Effect of Proton-Pump Inhibitor Treatment on Symptoms and Quality of Life in GERD Patients Depends on the Symptom-reflux Association
Bibliographic record
Abstract
BACKGROUND: Gastroesophageal reflux disease patients demonstrate various pathophysiologic backgrounds. Therefore, a heterogeneous response to proton-pump inhibitor (PPI) treatment can be expected. We investigated the effect of short-term PPI treatment on symptoms and quality of life (QOL) in primary care patients with and without pathologic esophageal acid exposure and in presence or absence of a positive association between symptoms and reflux episodes. STUDY: Seventy-four heartburn patients were categorized into 4 groups according to positive or negative symptom-reflux association, as expressed in symptom index, symptom sensitivity index, and symptom association probability (SAP) and presence or absence of pathologic reflux, defined as esophageal pH<4%>6% of the time (pH+/pH-). Overall and specific reflux symptoms were assessed 1 week before and the last week during a 2-week course of 40-mg esomeprazole daily. The QOL was scored by the Quality of Life in Reflux and Dyspepsia questionnaire 2 weeks before treatment and directly after. RESULTS: Using the SAP to assess symptom-reflux associations, the 4 groups [SAP+pH+(n=40); SAP+pH-(n=12); SAP-pH+(n=10); SAP-pH-(n=10)] had similar demographic characteristics. The SAP-pH- subgroup had the least overall symptom reduction (P<0.01) and in the SAP+pH+ subgroup the greatest heartburn symptom reduction was found (P<0.02). The residual symptom scores on treatment were lowest in SAP+pH+ and highest in SAP-pH- subgroups and relatively high in the SAP+pH-. QOL was severely reduced and SAP-pH- patients had the lowest QOL overall. Similar findings were made using symptom index and symptom sensitivity index. CONCLUSIONS: Symptomatic reflux patients without evidence of reflux disease on a 24-hour pH recording responded less favorably to PPI treatment than patients with a positive symptom-reflux association or with pathologic reflux.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".