Oyer SL, Anderson LC, Halum SL. Ann Otol Rhinol Laryngol. 2009;118(10):687-692.
OBJECTIVES: Although the Reflux Symptom Index (RSI) is a validated laryngopharyngeal reflux (LPR) outcomes tool, its predictive value for LPR is controversial. Because psychiatric problems may lead to exaggerated patient-perceived symptoms and RSI values, the aim of this study was to determine whether the positive predictive value of the RSI for pH probe–documented LPR is influenced by anxiety and depression.
RESULTS: We included 51 patients: 30 patients (59%) in the –PSY group and 21 patients (41%) in the +PSY group. The mean RSI of the +PSY group was higher than that of the –PSY group (p < 0.05), but the +PSY patients actually had a lower incidence of abnormal probe studies (p < 0.02). The positive predictive value of an elevated RSI for an abnormal pH probe study was poor in the +PSY patients (p = 0.495), but strong in the –PSY group (p = 0.004).
CONCLUSION: The presence of anxiety and depression impairs the predictive value of the RSI for LPR. This finding potentially explains some of the controversy over the diagnostic utility of the RSI.