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Article

Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study

by
Javier Ivanovychs Carrillo-Rojas
1,
Salvador Zavala-Villegas
1,
Guadalupe Morales-Osorio
1,
Fausto Daniel García-García
1,
Mauricio González-Navarro
2,
Viridiana Montsserrat Mendoza-Martínez
3 and
Nallely Bueno-Hernández
3,*
1
Gastroenterology Department, Specialty Hospital of the National Medical Center “La Raza”, Mexico City 02990, Mexico
2
Otorhinolaryngology Department, National Institute of Rehabilitation “Luis Guillermo Ibarra Ibarra”, Mexico City 14389, Mexico
3
Proteomics and Metabolomics Laboratory, Research Directorate, General Hospital of Mexico, “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico
*
Author to whom correspondence should be addressed.
Diagnostics 2025, 15(5), 636; https://doi.org/10.3390/diagnostics15050636
Submission received: 31 January 2025 / Revised: 27 February 2025 / Accepted: 4 March 2025 / Published: 6 March 2025
(This article belongs to the Special Issue Clinical Diagnosis of Otorhinolaryngology)
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Abstract

Background/Objectives: Gastroesophageal reflux disease (GERD) is associated with extraesophageal syndromes that require an objective assessment of abnormal acid exposure to establish the diagnosis. The COuGH RefluX score has been proposed as a diagnostic tool for GERD in patients with chronic laryngopharyngeal symptoms. The aim of the study was to evaluate the diagnostic performance of the COuGH RefluX score in the Mexican population. Methods: A cross-sectional study was conducted in patients with chronic laryngopharyngeal symptoms. Patients with cough, globus, sore throat, dysphonia, and/or throat clearing of ≥8 weeks duration, 24 h pH-impedance monitoring (pH-IM), and without objective evidence of GERD (defined as acid exposure time >6%) were included in the study. The COuGH RefluX score tool was applied and stratified as low probability with ≤2.5 points, intermediate probability with 3.0 to 4.5 points, and high probability with ≥5.0 points. The kappa test assessed the concordance between both tests; the area under the curve (AUR), sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive value (NPV) were calculated for each result. Results: 164 patients were included; the prevalence of GERD by pH-IM was 32% vs. 40.3% by COuGH RefluX score, the agreement was weak (κ = 0.34; p < 0.001), but the AUR was good (0.720 ± 0.17; p < 0.001). A score ≤ 2.5 had S = 49%, E = 88%, PPV = 89%, and NPV = 42% to rule out proven GERD, while a score ≥ 5 had S = 65%, E = 71%, PPV = 52%, and NPV = 82% for proven GERD. Conclusions: The COuGH RefluX score has low sensitivity but adequate specificity for GERD diagnosis in Mexican patients with chronic laryngopharyngeal symptoms.
Keywords: gastroesophageal reflux disease; esophageal pH monitoring; laryngopharyngeal reflux; chronic cough; diagnosis gastroesophageal reflux disease; esophageal pH monitoring; laryngopharyngeal reflux; chronic cough; diagnosis
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MDPI and ACS Style

Carrillo-Rojas, J.I.; Zavala-Villegas, S.; Morales-Osorio, G.; García-García, F.D.; González-Navarro, M.; Mendoza-Martínez, V.M.; Bueno-Hernández, N. Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study. Diagnostics 2025, 15, 636. https://doi.org/10.3390/diagnostics15050636

AMA Style

Carrillo-Rojas JI, Zavala-Villegas S, Morales-Osorio G, García-García FD, González-Navarro M, Mendoza-Martínez VM, Bueno-Hernández N. Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study. Diagnostics. 2025; 15(5):636. https://doi.org/10.3390/diagnostics15050636

Chicago/Turabian Style

Carrillo-Rojas, Javier Ivanovychs, Salvador Zavala-Villegas, Guadalupe Morales-Osorio, Fausto Daniel García-García, Mauricio González-Navarro, Viridiana Montsserrat Mendoza-Martínez, and Nallely Bueno-Hernández. 2025. "Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study" Diagnostics 15, no. 5: 636. https://doi.org/10.3390/diagnostics15050636

APA Style

Carrillo-Rojas, J. I., Zavala-Villegas, S., Morales-Osorio, G., García-García, F. D., González-Navarro, M., Mendoza-Martínez, V. M., & Bueno-Hernández, N. (2025). Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study. Diagnostics, 15(5), 636. https://doi.org/10.3390/diagnostics15050636

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