Measures of disease severity in eosinophilic esophagitis (EoE)

Dysphagia symptom questionnaire

The Dysphagia Symptom Questionnaire (DSQ) is a patient-reported assessment that measures the frequency and severity of dysphagia associated with eosinophilic esophagitis.²

How the DSQ is scored

The patients record their dysphagia symptoms within the previous 24 hours by answering up to 4 questions. Patients who answer “Yes” to Questions 1 and 2 proceed to Question 3; Question 4 is a standalone item. The maximum score is 84.² ≥ 8 diary entries taken over a 14-day period, and the average daily score is multiplied by 14.

Higher scores indicate more frequent or more severe dysphagia²

0 (no dysphagia)
84 (frequent, severe dysphagia)

5-Item EoE Symptom questionnaire

The 5-Item EoE Symptom Questionnaire (EoE-SQ-Frequency) is a patient- reported assessment that measures the frequency of symptoms other than dysphagia or swallowing pain, including chest pain, stomach pain, heartburn, regurgitation, and vomiting.³

How the EoE-SQ-Frequency is Scored

Patients record their symptoms using a 5-point response option ranging from “Never” to “More than once a day.” The maximum score is 25.³

EoE-SQ-frequency questionnaire³

During the past 7 days, how often did you experience...

Chest pain
Stomach pain
Burning feeling in your chest (heartburn)
Food or liquid coming back up into your throat
Throw up

Higher scores indicate greater symptom severity and frequency³

5 (no symptoms)
25 (frequent symptoms)

References

O’Shea KM, Aceves SS, Dellon ES, et al. Pathophysiology of eosinophilic esophagitis. Gastroenterology. 2018;154(2):333-345. doi:10.1053/j.gastro.2017.06.065
Hudgens S, Evans C, Phillips E, Hill M. Psychometric validation of the Dysphagia Symptom Questionnaire in patients with eosinophilic esophagitis treated with budesonide oral suspension. J Patient Rep Outcomes. 2017;1(3):1-11. doi:10.1186/s41687-017-0006-5
Dellon ES, et al. Dupilumab improves health-related quality of life and reduces symptom burden in patients with eosinophilic esophagitis: results from part A of a randomized, placebo-controlled, three-part, phase 3 study. Poster presented at: 2021 Virtual Annual Meeting of the American Academy of Allergy, Asthma, and Immunology (AAAAI); February 26 - March 1, 2021.
Dellon ES, Gupta SK. A conceptual approach to understanding treatment response in eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2019;17(11):2149-2160. doi:10.1016/j.cgh.2019.01.030
Wen T, Stucke EM, Grotjan TM, et al. Molecular diagnosis of eosinophilic esophagitis by gene expression profiling. Gastroenterology. 2013;145(6):1289-1299. doi:10.1053/j.gastro.2013.08.046
Dellon ES, Veerappan R, Selitsky SR, et al. A gene expression panel is accurate for diagnosis and monitoring treatment of eosinophilic esophagitis in adults. Clin Transl Gastroenterol. 2017;8(2):1-8. doi:10.1038/ctg.2017.2
Collins MH, et al. Newly developed and validated eosinophilic esophagitis histology scoring system and evidence that it outperforms peak eosinophil count for disease diagnosis and monitoring. Dis Esophagus. 2017;30(3):1-8. doi:10.1111/dote.12470
Wechsler JB, et al. Eosinophilic esophagitis reference score accurately identifies disease activity and treatment effects in children. Clin Gastroenterol Hepatol. 2018;16(7):1056-1063. doi:10.1016/j. cgh.2017.12.019
Hirano I, et al. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system. Gut. 2013;62(4):489-495. doi:10.1136/ gutjnl-2011-301817
Lucendo AJ, Molina-Infante J, Arias Á, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J. 2017;5(3):335-358. doi:10.1177/2050640616689525
Safroneeva E, Straumann A, Coslovsky M, et al; International Eosinophilic Esophagitis Activity Index Study Group. Symptoms have modest accuracy in detecting endoscopic and histologic remission in adults with eosinophilic esophagitis. Gastroenterology. 2016;150(3):581-590.e4. doi:10.1053/j.gastro.2015.11.004
COREOS Collaborators: Ma C, Schoepfer AM, et al. Development of a core outcome set for therapeutic studies in eosinophilic esophagitis (COREOS) [published online ahead of print, 2021 Jul 6]. J Allergy Clin Immunol. 2021;S0091-6749(21)01059-9. doi:10.1016/j.jaci.2021.07.001