TRANSLATION AND VALIDATION OF THE REFLUX SIGN ASSESSMENT INTO BRAZILIAN PORTUGUESE

INTRODUCTION: Laryngopharyngeal reflux (LPR) remains a diagnostic challenge. In order to minimize subjectivity of the clinical diagnosis of this most prevalent disease, a number of diagnostic instruments have been proposed, which over time have proven to be poorly specific. In 2019, a new score based on both laryngeal and extralaryngeal findings associated with LPR, called the Reflux Sign Assesment (RSA), was published by a group of European researchers. The RSA demonstrated high intra- and interrater reliabilities and responsiveness to treatment. OBJECTIVE: To translate and validate the Brazilian Portuguese version of the Reflux Sign Assesment. MATERIAL AND METHOD: The English version of the RSA was translated into Brazilian Portuguese and applied prospectively to the videolaryngoscopic examinations of 106 adults (88 with LPR and 24 healthy controls) by two groups of examiners (two experienced laryngologists and two general otolaryngologists). For assessment of reproducibility and temporal stability a random sample of 60 subjects (40 patients and 20 controls) were tested and re-tested. RESULTS: A statistically significant difference was observed in the mean RSA between patients with LPR (23.58+5.63) and controls (10.66+1.34) bay all four examiners (p<0.001). The interclass correlation coefficient (ICC) comparing test and re-test between senior and junior raters was high (R1=0.956; R2= 0.948). CONCLUSION: The Brazilian Portuguese version of the RSA proved to be a reliable and reproducible instrument for the diagnosis of LPR with a sensitivity of 86.01%, a specificity of 91.84%, a positive predictive value of 95.80%, and a negative predictive value was 74.04%.