Gastroenterology Division, McMaster University, Hamilton, Ontario; and Department of General Practice and Primary Care, University of Birmingham, Edgbaston, Birmingham, United Kingdom

Correspondence: Paul Moayyedi, BSc, MB ChB, PhD, MPH, FRCP, Professor of Gastroenterology, Department of Medicine, Division of Gastroenterology, McMaster University Medical Center, 1200 Main St., West, HSC 3N51D, Hamilton, Ontario, Canada L8N 3Z5. e-mail: moayyep@mcmaster.ca.

Received 31 October 2004; Accepted 2 November 2004.

Abstract

The optimum approach for evaluation of reflux symptoms is uncertain. Trials have used a variety of methods, and it is important that a more consistent approach is taken. One piece of the puzzle is whether symptoms should be assessed by a clinician or directly by a patient completed questionnaire. McColl et al. suggest that clinicians tend to underestimate the severity of symptoms and that a more patient-centered approach should be used to elicit symptoms. This has important implications for the development of future questionnaires in gastroesophageal reflux and other gastrointestinal diseases.