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December 31, 2020
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Short esophageal hypervigilance scale compares well with longer test

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An esophageal hypervigilance and anxiety scale with fewer questions was reliable for measuring symptom severity and quality life, according to study results.

Tiffany H. Taft, PsyD, MIS, of Northwestern University Feinberg School of Medicine, and colleagues wrote that they previously developed a 15-question esophageal hypervigilance and anxiety scale (EHAS), but a scale with a minimum number of questions is more clinically useful.

“The current version of the EHAS includes 15 questions, which may preclude it being widely used in clinical practice,” they wrote. “Therefore, we aim to develop a short form of the EHAS while maintaining its reliability and construct validity.”

Researchers conducted a retrospective review of a registry of patients who visited an esophageal motility clinic for diagnostic testing. They included patients who completed their 15-question scale and questionnaires assessing dysphagia severity and health-related quality of life at the time of motility testing.

After identifying scale items for possible removal, investigators tested the EHAS and the EHAS-short form (SF) for reliability and concurrent validity.

The study comprised 3,976 patients, which included patients with achalasia or esophagogastric junction outflow obstruction (30%), eosinophilic esophagitis (13%), GERD (13%) and normal activity (39%).

After their analysis, Taft and colleagues removed eight items from the EHAS, creating the single scale, seven-item EHAS-SF, scored from 0 to 28.

They found that the new scale showed good internal consistency (alpha = 0.91) and split-half reliability (0.88), which was similar to findings in the full EHAS both in the current study and previous studies. The EHAS-SF also had concurrent validity with measures of dysphagia and health-related quality of life.

“As these constructs consistently demonstrate an important role in both dysphagia severity and health-related quality of life, it behooves clinicians to assess their presence in every esophageal patient,” Taft and colleagues wrote. “Baseline scores from EHAS-SF may be relevant considerations for treatment planning, including if/when psychogastroenterology services are integrated into patient care.”