Validity and Reliability of the Reflux Sign Assessment

2019 ◽  
Vol 129 (4) ◽  
pp. 313-325 ◽  
Author(s):  
Jérôme R. Lechien ◽  
Alexandra Rodriguez Ruiz ◽  
Didier Dequanter ◽  
Francois Bobin ◽  
Francois Mouawad ◽  
...  
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Control Group ◽  
Validity And Reliability ◽  
The Mean ◽  
Asymptomatic Individuals ◽  
Clinical Instrument ◽  
Physical Findings ◽  
Responsiveness To Change ◽  
Kendall’S W

Objective: To develop and validate the Reflux Sign Assessment (RSA), a clinical instrument evaluating the physical findings of laryngopharyngeal reflux (LPR). Methods: A total of 106 patients completed a 3-month treatment based on the association of diet, pantoprazole, alginate, or magaldrate with the LPR characteristics (acid, nonacid, mixed). Forty-two asymptomatic individuals completed the study (control group). The RSA results and reflux finding score (RFS) were documented for the LPR patients at baseline and after treatment. Intrarater reliability was assessed through a test-retest blinded evaluation of signs (7-day intervals). Interrater reliability was assessed by comparing the RSA evaluations of three blinded otolaryngologists through Kendall’s W. Responsiveness to change was evaluated through a comparison of the baseline and 3-month posttreatment findings. The RSA cutoffs for determining the presence and absence of LPR were examined by receiver operating characteristic (ROC) analysis. Results: A total of 102 LPR patients completed the study (68 females). The mean age was 53 years. The mean RSA at baseline was 25.95 ± 9.58; it significantly improved to 18.96 ± 7.58 after 3 months of therapy ( P < .001). RSA exhibited good intra- ( r = 0.813) and interrater (Kendall’s W = 0.663) reliabilities (N = 56). There was no significant association between the RSA, gastrointestinal endoscopy findings, and the types of reflux (acid, nonacid, or mixed) according to impedance-pH monitoring. An RSA >14 may be suggestive of LPR. Conclusion: The RSA is a complete clinical instrument evaluating both laryngeal and extralaryngeal findings associated with LPR. The RSA demonstrated high intra- and interrater reliabilities and responsiveness to change.

The comparison of an empiric proton pump inhibitor trial vs 24-hour double-probe Ph monitoring in laryngopharyngeal reflux

2003 ◽  
Vol 117 (5) ◽  
pp. 386-390 ◽  
Author(s):  
Cem Bilgen ◽  
Fatih Ögüt ◽  
Hatice Kesimli-Dinç ◽  
Tayfun Kirazli ◽  
Serhat Bor
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Control Group ◽  
Study Group ◽  
Double Probe ◽  
Alternative Method ◽  
Significant Difference ◽  
Physical Findings

Laryngopharyngeal reflux (LPR), which is defined as the backflow of gastric contents into the upper aerodigestive tract, is a relatively common disorder. However, its diagnosis still poses many problems. Twenty-four-hour double-probe pH monitoring is currently the diagnostic test of choice, but it has many disadvantages. Thus, an empiric trial of antireflux therapy has been suggested as an alternative method for diagnosis. The purpose of this article is to evaluate the validity of this alternative method in the management of LPR. The study group consisted of 36 patients with symptoms and physical findings suggesting LPR. The control subjects were 23 healthy adults. Twenty-four-hour double-probe pH monitoring was performed both in the study group and the control group, and the results were compared. In addition, the symptoms and physical findings in the study group was scored by the modified reflux symptom index (MRSI) and reflux finding score (RFS) at four intervals: before the start of therapy and at the second, fourth and sixth months of the therapy. The results of the 24-hour double-probe pH monitoring showed no significant difference between the study and the control groups (p>0.05). In the study group, the MRSI before the therapy was 13.6±4.4. This index improved significantly to 4.3±1.9 at the second month; to 1.5±0.6 at the fourth month, and to 0.5±0.2 at the sixth month of the therapy (p<0.05). The RFS before the start of the therapy was 14.8±3.8; and it improved significantly to 7.7±3.8 at the second month; to 4.5±2.3 at the fourth month, and to 1.4±0.9 at the sixth month of the therapy (p<0.05). The significant improvement in the MRSI and the RFS during the course of proton pump inhibitor therapy relates the patients’ symptoms and physical findings to LPR. This implies the validity of the method, not only in the treatment of LPR, but in the diagnosis of this disorder, as well. Unfortunately, 24-hour double-probe pH monitoring has failed to differentiate LPR patients from healthy individuals.

Does laryngopharyngeal reflux affect healing and recovery after tonsillectomy?

2007 ◽  
Vol 122 (6) ◽  
pp. 603-608 ◽  
Author(s):  
S Elwany ◽  
Y A Nour ◽  
E A Magdy
Keyword(s):  
Wound Healing ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Blinded Study ◽  
Group A ◽  
Group B ◽  
Control Group Group

AbstractIntroduction:Laryngopharyngeal reflux is increasingly being implicated in several otolaryngological disorders.Aims:To study a potential correlation between pre-operative laryngopharyngeal reflux and wound healing and recovery after tonsillectomy, based on subjective and objective findings.Materials and methods:A prospective, blinded study was undertaken, including 60 patients scheduled for tonsillectomy, divided into two equal groups: a study group (group A) with pre-operative laryngopharyngeal reflux documented using ambulatory 24-hour pH monitoring; and a control group (group B) without laryngopharyngeal reflux.Results:Group A had significantly higher pain scores on the seventh and 14th post-operative days (p = 0.022 and p = 0.000, respectively) and took a significantly longer time to return to normal eating (p = 0.013), compared with group B. Group A also showed significantly slower healing on the seventh and 14th post-operative days, as estimated by assessing the grade of post-operative slough formation (p = 0.016 and p = 0.029, respectively). A significant correlation between the number of pharyngeal reflux episodes and the degree of post-operative slough was also found.Conclusions:Laryngopharyngeal reflux can significantly decrease wound healing following tonsillectomy. Therefore, pre-operative recognition and management of this condition is desirable in order to eliminate its negative post-operative effect.

The Significance of Laryngopharyngeal Reflux in Benign Vocal Mucosal Lesions

2009 ◽  
Vol 141 (3) ◽  
pp. 369-373 ◽  
Author(s):  
Jae Ho Chung ◽  
Kyung Tae ◽  
Yong Seop Lee ◽  
Jin Hyeok Jeong ◽  
Seok Hyun Cho ◽  
...  
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Medical Center ◽  
Control Group ◽  
Etiologic Factor ◽  
Vocal Polyp ◽  
Total Reflux ◽  
Increased Risk ◽  
Reinke’S Edema ◽  
Mucosal Lesions

OBJECTIVE: To determine the significance of laryngopharyngeal reflux (LPR) in benign vocal mucosal lesions. STUDY DESIGN AND SETTING: A case-control study at the tertiary referral medical center. SUBJECTS AND METHODS: From April 2003 to December 2006, we studied 110 patients with benign vocal mucosal lesions who had undergone 24-hour ambulatory double pH monitoring. The control group included 200 patients who had undergone ambulatory 24-hour double-probe pH monitoring due to laryngopharyngeal reflux-related symptoms without specific findings of benign vocal mucosal lesions. Reflux symptom index and reflux finding score were measured. We compared the prevalence of pathologic laryngopharyngeal reflux and various parameters of the pH monitoring such as total reflux number, fraction time of pH below 4 in various positions, and DeMeester scores. RESULTS: The prevalence of pathologic laryngopharyngeal reflux was 65 percent in the control group, 66 percent in vocal nodule group, 75 percent in the vocal polyp group, and 90 percent in the Reinke's edema group. Patients with Reinke's edema had a significantly higher prevalence of pathologic laryngopharyngeal reflux than controls ( P = 0.016). LPR was associated with a significantly increased risk of Reinke's edema (odds ratio: 4.846, 95% confidence interval 1.093∼21.492). Total reflux number and DeMeester scores in the Reinke's edema group and fraction time of pH below 4 in the supine position in the vocal polyp group were significantly higher than those in the control group. CONCLUSION: Laryngopharyngeal reflux might play a role as an etiologic factor in Reinke's edema and vocal polyps.

scholarly journals Effect of Education Based on Extended Theory of Planned Behavior on Exclusive Breastfeeding in Pregnant Women in Darmian in 2017

Health Scope ◽  
2020 ◽  
Vol 9 (3) ◽  
Author(s):  
Hajar Rasoli ◽  
Gholamreza Masoudy ◽  
Hossein Ansari ◽  
Hossein Bagheri
Keyword(s):  
Theory Of Planned Behavior ◽  
Pregnant Women ◽  
Planned Behavior ◽  
Exclusive Breastfeeding ◽  
Intervention Group ◽  
Control Group ◽  
Validity And Reliability ◽  
Extended Theory ◽  
The Mean ◽  
And Control

Background: Appropriate breastfeeding reduces health disorders and death among infants. Objectives: The present study was conducted to evaluate the effects of educational intervention based on the extended theory of planned behavior. Methods: In this semi-experimental study, 168 pregnant women from 20 health centers were allocated into intervention and control groups by a multi-stage sampling method. The data collecting tool included demographic and constructs of an extended theory of planned behavior. The validity and reliability of the questionnaire were confirmed by an expert panel and Cronbach's alpha test, respectively. The educational methods encompassed face to face training, pamphlet and flashcards distribution, and clip presentation. Two 45-minute educational sessions were conducted; the data were recollected 6 months after the delivery. Results: The mean ages of the intervention and control group were 29 ± 6 and 28.7 ± 5.9. The pregnancy rate and age of the pregnancy in the intervention group were 2.7 ± 1.4 and 29 weeks, respectively. After the intervention, the mean score of the behavior in the intervention group increased compared to the control group. The intention (B = 0.4, P = 0.01) and perceived behavior control (B = 0.42, P = 0.03) were the predictors of the behavior. Conclusions: The structures of the extended theory of planned behavior are suitable framework to promote exclusive breastfeeding among pregnant women.

scholarly journals Laryngopharyngeal pH Monitoring in Patients With Idiopathic Pulmonary Fibrosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yiliang Su ◽  
Li Shen ◽  
Fen Zhang ◽  
Xing Jiang ◽  
Xiaofeng Jin ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Supine Position ◽  
Ph Value ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Upright Position ◽  
Index Score ◽  
Control Group ◽  
Healthy Individuals

Background: Patients with idiopathic pulmonary fibrosis (IPF) often have irritating persistent dry cough. Possible correlations between dry cough and laryngopharyngeal reflux (LPR) remain unclear.Methods: 44 patients with IPF and 30 healthy individuals underwent 24 h laryngopharyngeal pH monitoring. Ryan index score was calculated. Patients’ demographic and clinical data were collected.Results: 44 patients with IPF and 30 healthy individuals were included. The proportions of men and smokers were significantly higher in IPF group than control group (All p &lt; 0.01). The average laryngopharyngeal pH value for 24 h was similar in the IPF (7.11 ± 0.08) group and control group (7.09 ± 0.06). According to the percentage duration of pH &lt; 6.5, pH6.5–7.5, and pH &gt; 7.5 in the overall measure duration, the patients were classified into three pH groups. In entire pH monitoring duration, the proportion of pH &gt; 7.5 group in IPF patients was higher than control group; at upright position, the proportion of pH &gt; 7.5 group in IPF patients was higher than control group; at supine position, the proportion of pH &lt; 6.5 group in IPF patients was higher than control group (All p &lt; 0.01). Seven patients had Ryan index score&gt;9.41 at upright position. All patients had Ryan index score&lt;6.79 at supine position. Four patients showed significantly higher and one patient had significantly lower average pH at coughing than the overall average pH (All p &lt; 0.05).Conclusions: Patients with IPF may have LPR. Basic and acidic LPR may likely occur at upright and supine position, respectively. Ryan index may not accurately reflect LPR in patients with IPF.

scholarly journals Changing Trends of Color of Different Laryngeal Regions in Laryngopharyngeal Reflux Disease

2019 ◽  
Vol 99 (8) ◽  
pp. 543-547
Author(s):  
Chen Du ◽  
Paige Thayer ◽  
Yan Yan ◽  
Qingsong Liu ◽  
Li Wang ◽  
...  
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Vocal Folds ◽  
Control Group ◽  
Negative Group ◽  
Positive Group ◽  
Changing Trends ◽  
Significant Difference ◽  
False Vocal ◽  
And Control

Introduction: In our previous study, we demonstrated that there might be correlations between laryngopharyngeal reflux disorder and the hue value of laryngoscopic images. And we found that different regions of larynx have different hue values. It was hypothesized that the degree of inflammation varies between different laryngeal regions, due to an acid reflux pattern. Objective: The objective of this study was to compare the changing trends of hue values of different laryngeal regions in patients with laryngopharyngeal reflux (LPR) disease. Methods: Ninety-seven patients, including 20 pH-positive, 19 pH-negative were tested for LPR through multichannel intraluminal impedance 24-hour pH monitoring, and 58 controls with reflux symptom index less than 13. Laryngoscopic images of all patients were obtained. The hue values of 7 areas of interest, including both sides of the true vocal folds, the false vocal folds, the arytenoids, and the interarytenoid space, were quantified using a hue calculation. The analysis of variance analysis was applied to find if there was significant difference between different groups within each region. Results: (1) In the regions of both sides of the true vocal folds and interarytenoid, there was no significant difference between positive group and negative group; (2) in the regions of both sides of false vocal folds, there was no significant difference between negative group and control group; (3) in the regions of both sides of arytenoids, there was neither significant difference between positive group and negative group nor between negative group and control group; (4) in other comparisons, there were significant differences. Conclusion: Hue values of separate laryngeal regions are different. In negative group, the hue values of interarytenoid region are similar with positive group, and the sensitivity to the acid are different from different regions. The sensitivity in the true vocal folds may be present.

The Impact of Using Learning Media Robot Transporter toward Learning Outcome and Learning Gain of Students

2020 ◽  
pp. 284-292
Author(s):  
Chandra Ainur Rizki ◽  
I Gusti Putu Asto Buditjahjanto ◽  
Bambang Suprianto
Keyword(s):  
Student Learning ◽  
Learning Outcomes ◽  
Student Learning Outcomes ◽  
Control Group ◽  
Validity And Reliability ◽  
Learning Gain ◽  
Gain Score ◽  
Post Test ◽  
The Mean ◽  
The Impact

This study aims 1) to determine the validity and reliability of the robot transporter learning media instrument, 2) to know the differences in the student learning outcomes between the use of robot transporter and PowerPoint as learning media, and 3) to know how much the learning gain score from the use of these two media. A pre-test-post-test comparison group design type was used. A sample of 60 vocational students participated in two groups, the experimental group (N = 30) and the control group (N = 30).  The results show that the robot transporter learning media is categorized as valid and reliable. The t-test result is 12.589 greater than the t table, namely 2.3596 with a significance of 0.05. Therefore, there is a difference in student learning outcomes. The mean of learning gain score on the robot transporter is 0.694, higher than the mean of learning gain score on the PowerPoint which is 0.289. The use of robot transporter as learning media can help students to be more interactively involved in learning. This is indicated by the students' post-test scores and the value of the gain learning in the experimental class was higher than the control class.

scholarly journals Laryngopharyngeal pH monitoring in patients with interstitial lung diseases

2019 ◽  
Author(s):  
Yiliang Su ◽  
Li Shen ◽  
Fen Zhang ◽  
Xing Jiang ◽  
Xiaofeng Jin ◽  
...  
Keyword(s):  
Clinical Data ◽  
Supine Position ◽  
Lung Diseases ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Interstitial Lung Diseases ◽  
Upright Position ◽  
Index Score ◽  
Control Group ◽  
Healthy Individuals

Abstract Background Patients with interstitial lung diseases (ILDs) often have irritating persistent dry cough. Possible correlations between dry cough and laryngopharyngeal reflux (LPR) remain unclear. Methods 44 patients with ILDs and 30 healthy individuals underwent 24-hour laryngopharyngeal pH monitoring. Ryan index score was calculated. Patients’ demographic and clinical data were collected. Results 44 patients (23 cases of IPF and 21 cases of CTD-ILD) and 30 healthy individuals were included. The proportions of men and smokers were significantly higher in IPF group than in CTD-ILD group and control group (All P<0.01). Other demographic and clinical data were similar in IPF and CTD-ILD group. According to the percentage duration of pH<6.5, pH6.5-7.5, and pH>7.5 in the overall measure duration, the patients were classified into three pH groups. In entire pH monitoring duration, the proportion of pH>7.5 group in ILD patients was higher than control group; at upright position, the proportion of pH>7.5 group in ILD patients was higher than control group; at supine position, the proportion of pH<6.5 group in ILD patients was higher than control group (All P<0.01). Seven patients had Ryan index score>9.41 at upright position. All patients had Ryan index score<6.79 at supine position. Four patients showed significantly higher and one patient had significantly lower average pH at coughing than the overall average pH (All P<0.05). Conclusions Patients with ILDs may have LPR. Basic and acidic LPR may likely occur at upright and supine position, respectively. Ryan index may not accurately reflect LPR in patients with ILDs.

scholarly journals The Effectiveness of a Discovery-Learning Strategy in the Acquisition of Scientific Concepts Among Kindergarten Students in Jordan

2019 ◽  
Vol 13 (5) ◽  
pp. 122
Author(s):  
Intesar Tannous
Keyword(s):  
Learning Strategy ◽  
Kindergarten Students ◽  
Discovery Learning ◽  
Control Group ◽  
Scientific Concepts ◽  
Validity And Reliability ◽  
Significant Difference ◽  
Post Test ◽  
The Mean ◽  
Experimental Group

The present study aimed to detect the effectiveness of using a discovery-learning strategy in the acquisition of scientific concepts among kindergarten students whose ages are between 5-6 years. The study used the experimental method through semi-experimental design with pre and post-test for the experimental and control groups. To achieve the goal of the study, a visual test for the scientific concepts was developed. After verifying the validity and reliability of the scale, it was applied to the study sample, which included 49 boys and girls randomly assigned to two groups,: An experimental group consisting of 24 boys and girls who were taught by using a discovery-learning strategy, and a control group consisting of 25 boys and girls were taught by using the traditional methods. The results of variance analysis showed a statistically significant difference at the level &alpha; = 0.05 between the mean scores of the responses of the control and experimental groups&rsquo; participants in the post-test of scientific concepts, attributed to the use of the discovery-learning strategy, and for the benefit of the experimental group. The study found no statistically significant differences at the level of &alpha; = 0.05 between the mean scores of the experimental group&#39;s participants in the post-test of scientific concepts attributed to gender variable, nor there was any statistical effect of interaction between gender and teaching strategy. In the light of these results, the study concluded the effectiveness of using a discovery-learning strategy in the acquisition of scientific concepts among kindergarten children.

scholarly journals Effectiveness of Self-Explanations Strategy in Developing Physical Concepts and Awareness of future envisioning of secondary stage students: فاعلية استراتيجية التفسيرات الذاتية في تنمية المفاهيم الفيزيائية والوعي باستشراف المستقبل لدى طلاب المرحلة الثانوية

2021 ◽  
Vol 5 (49) ◽  
pp. 74-51
Author(s):  
Naif Helal Zabin Al-Juaid, Muhsen Mustafa Mohammed Abdel-Kad Naif Helal Zabin Al-Juaid, Muhsen Mustafa Mohammed Abdel-Kad
Keyword(s):  
Experimental Approach ◽  
Statistical Processing ◽  
Control Group ◽  
Validity And Reliability ◽  
Scientific Content ◽  
Secondary Stage ◽  
Post Test ◽  
Quasi Experimental ◽  
The Mean ◽  
Experimental Group

Thesis Objectives: The thesis aimed at investigating the effectiveness of using Self-Explanations Strategy in developing physical concepts and the awareness of future envisioning of secondary stage students. To achieve the research objectives, the quasi-experimental approach was used through applying the experiment to two groups (the control and the experimental groups). The sample comprised (51) students; (25) at first secondary term students in the experimental group and (26) students in the control group. Thesis procedures: The scientific content of chapter seven, entitled "gravity" in the physics textbook for the first secondary grade students (second term), was structured and organized according to the philosophy and nature of Self-Explanations Strategy. Then, two tools were prepared; the physical concepts test and the awareness of future envisioning scale. The Validity and reliability of the two tools were applied through applying them on a pilot group of (30) students. They were pre-applied, then the experimental group was taught using Self-Explanations Strategy and the control group was taught using the traditional method. Then, the thesis tools were post-applied to get the raw scores to apply the statistical processing in order to get the results. Thesis results: The results revealed the effectiveness of Self- Explanations Strategy in in developing physical concepts and the awareness of future envisioning. Whereas there statistically significant differences at (a≤0.05) level were existed between the mean scores of the control and the experimental groups students in the post test of concepts as well as the future awareness scale in favor of the experimental group.

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