The Gastroesophageal Reflux Disease-Health-Related Quality-Of-Life (GERD-HRQL) scale was developed to objectively quantify symptom severity. It was compared to a "gold standard" health survey, the SF-36. Forty-three patients treated either medically or surgically for gastroesophageal reflux disease were asked to complete both the GERD-HRQL and the SF-36. They were asked the following: (1) Which questionnaire do you like best? (2) Which questionnaire was easier to understand? (3) Which questionnaire was more reflective of the problems you have with reflux disease? (4) Given the choice, which questionnaire would you rather fill out? Patients were asked to state their overall satisfaction with their present reflux symptom conditions. Multivariate analysis showed that the only significant predictor of patient satisfaction was the total GERD-HRQL score (P <0.00001). There were differences in the SF-36 domains of physical function (88.7 vs. 65.3; P = 0.004) and general health (68 vs. 46.5; P = 0.006). There were no correlations between the total GERD-HRQL scores and the SF-36 domain scores. Fifty-nine percent of patients preferred the GERD-HRQL questionnaire, 62% felt it was easier to understand, 86% felt it was more reflective of their symptoms, and 67% said they would rather use it over the SF-36. The GERD-HRQL better assesses symptom severity for gastroesophageal reflux disease than the generic SF-36