The Journal of Laryngology & Otology

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Non-voice-related throat symptoms: comparative analysis of laryngopharyngeal reflux and globus pharyngeus scales

R A Cathcarta1 c1, N Steena2, B G Natesha1, K H Alia3 and J A Wilsona1

a1 Department of Otorhinolaryngology, Freeman Hospital, Newcastle upon Tyne, UK

a2 Institute of Health and Society, Newcastle upon Tyne, UK

a3 Department of Otorhinolaryngology, University Hospitals of Leicester, UK


Background: This study calculated the comparability of two throat symptom assessment scales devised to evaluate either laryngopharyngeal reflux or globus.

Setting: United Kingdom hospital out-patient departments.

Method: A total of 334 subjects, with and without throat symptoms, completed the Reflux Symptom Index and/or the Glasgow and Edinburgh Throat Scale. The following were calculated for the resultant data: Cronbach's α coefficient, principal component analysis, Kaiser normalisation, varimax and oblimin rotation, and eigenvalues.

Results: Analysis of data from the Reflux Symptom Index and the Glasgow and Edinburgh Throat Scale revealed clearly similar symptom domains regarding (1) coughing and blockage, and (2) globus or postnasal drip or throat-clearing, as did combined analysis of their amalgamated items. Both instruments had good overall internal consistency (α = 0.75 and 0.81, respectively). The ‘heartburn or reflux’ item in the Reflux Symptom Index mapped poorly to each underlying factor.

Discussion: The most commonly used laryngopharyngeal reflux and globus assessment questionnaires appear to detect very similar symptom clusters. The management of throat disorders may previously have been over-reliant on the presenting pattern of throat symptoms. Our findings indicate a need to revisit the traditional clinical classification of throat symptoms.

(Accepted April 29 2010)

(Online publication October 01 2010)


c1 Address for correspondence: Mr Russell Cathcart, c/o ENT Department, Freeman Hospital, Newcastle NE77DN, UK Fax: +44 (0)191 2231246 E-mail:


Data from this work were presented in a free paper at the Otorhinolaryngological Research Society Meeting, 21 April 2006, Bath, United Kingdom.

Mr R A Cathcart takes responsibility for the integrity of the content of the paper

Competing interests: None declared