Measuring gastroesophageal reflux symptoms: musings from Marrakech.

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.