Study designs of evaluations included in the review
Randomised placebo controlled trials (RCTs) or placebo-controlled clinical trials were eligible for inclusion.
Specific interventions included in the review
Studies of medical or surgical anti-reflux treatment for laryngeal or pharyngeal symptoms assumed to be associated with GERD were eligible for inclusion. All of the included studies used proton-pump inhibitors (PPIs) such as pantoprazole (80 mg for 12 weeks), lansoprazole (60 mg for 12 weeks), omeprazole (80 mg for 12 weeks), rabeprazole (40 mg for 8 weeks) and esomeprazole (80 mg for 16 weeks). No studies assessing surgical interventions met the inclusion criteria for this review.
Participants included in the review
Studies of adults with laryngeal or pharyngeal symptoms lasting not less than 2 weeks and attributed to GERD were eligible for inclusion. Studies of patients with other specific identifiable causes of laryngeal or pharyngeal symptoms supported by physical examination and/or appropriate tests were excluded. The participants included in the study were all aged 18 years or older and were experiencing a variety of symptoms: cough, nocturnal cough, globus, sore throat, hoarseness, dysphonic attacks, frequent clearing of the throat and non-productive cough.
Outcomes assessed in the review
Studies that assessed the proportion of patients reporting an improvement in symptoms after treatment were eligible for inclusion. Definition of a ‘responder’ was taken as that chosen by the authors of the included studies.
How were decisions on the relevance of primary studies made?
Two reviewers independently selected the studies and resolved any disagreements on inclusion through recourse to a third reviewer.