Evaluating the Parameters Used to Diagnose GERD in Infants

The effectiveness symptom-reflux association analysis, used to diagnosed GERD in infants, is the focus of a new study by researchers from Switzerland.

New research published in the World Journal of Gastroenterology examines three commonly used symptom-reflux association analysis (SAA) parameters that are used to diagnose GERD in infants.

Lead researcher Samuel C Lüthold, MD, division of gastroenterology, department of pediatrics, Hospital of Fribourg in Switzerland, and his team examined three SAA parameters commonly used to diagnosed GERD in infants: symptom index (SI), symptom sensitivity index (SSI), and symptom association probability (SAP). Among the group of 23 infants who presented with cough and irritability — two non-specific symptoms of GERD — SI, SSI, and SAP were evaluated. According to the WJG abstract, “SI, SSI and SAP showed non-identical classification of normal and abnormal cases in 39.2% of the infants” when the researchers evaluated the GER-irritability association.

In addition, “when irritability was taken as a symptom, there was only a poor inter-parameter association between SI and SSI, and between SI and SAP (Kendall’s tau b = 0.37, P < 0.05; Kendall’s tau b = 0.36, P < 0.05, respectively).” Finally, when evaluating the GER-cough association, “SI, SSI and SAP showed non-identical classification of normal and abnormal cases in 52.2% of the patients,” but when cough was taken as a symptom, “only SI and SSI showed a poor inter-parameter association (Kendall’s tau b = 0.33, P < 0.05).”

As the study revealed that the diagnosis of GERD in infants cannot be based on only one SAA parameter, the researchers believe that identification of this condition “should be based on a combination of pH/MII-monitoring, SAA results as well as on other factors such as clinical judgment, gastroscopy and follow-up under medical therapy.”

“In infants investigated for suspected GERD with pH/MII-monitoring, SI, SSI and SAP showed a poor inter-parameter association and important disagreements in diagnostic classification,” the researchers concluded. “These limitations must be taken into consideration when interpreting the results of SAA in infants.”