Validity and Reliability of the Burp Score

Objective To investigate the validity and the reliability of the Burp Score, a patient‐reported outcome questionnaire documenting the retrograde cricopharyngeal dysfunction (R‐CPD) symptoms. Study Design Prospective controlled study. Methods R‐CPD Patients were consecutively recruited from 2 hospitals between September 2024 and April 2025. Patients and healthy individuals completed the Burp score twice within a 7‐day period to assess test‐retest reliability. Internal consistency was measured using Cronbach's α for the Burp items in patients and controls. Validity was evaluated by comparing the Burp with the reflux symptom score‐12 (RSS‐12). The Burp score was completed 3 to 6 months after the EMG‐guided botulinum toxin injection (BTI) to evaluate the responsiveness to change. The minimal clinically important difference (MCID) was evaluated by receiver operating characteristic (ROC) analysis. Results Eighty R‐CPD patients (46 females) completed the baseline evaluations. Of the 134 screened controls, 34 (22.4%) were excluded because unable to burp. Test‐retest reliability ( r s = 0.911) and internal consistency reliability ( α = 0.870) were high. Burp Score reported a moderate but significant external validity indicated by a significant correlation with the RSS‐12 ( r s = 0.533). Internal validity was excellent regarding the significant differences between the Burp Score of R‐CPD patients versus controls ( P = .001). Burp score significantly decreased from pre‐ to posttreatment, indicating a high responsiveness to change. ROC analysis reported a MCID of 11.0 to consider the treatment partially or fully effective. Conclusion The Burp score is a valid and reliable patient‐reported outcome questionnaire documenting R‐CPD symptoms and assessing their related pretreatment to posttreatment severity and frequency.