A new simple score of chronic cough: cough evaluation test

Zhan, Wenzhi; Zhang, Liting; Jiang, Mei; Chen, Meihua; Yuan, Xiaoling; Sun, Jianxin; Xu, Pusheng; Wu, Feng; Zhang, Chunlai; Luo, Wei; Chen, Xiaomei; Hu, Li; Lai, Kefang

doi:10.1186/s12890-020-1106-1

Cited by 21 publications

(13 citation statements)

References 26 publications

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“…The search identified eligible studies addressing item generation or development of a number of cough-specific PROMs: CCIQ [8], Cough and Sputum Questionnaire [32], COAT [10], Cough Evaluation Test (CET) [11], CSD [15], Cough Severity Index [65], CQLQ [9], CSS [14], Hull Airway Reflux [44] Questionnaire [59], LCQ [7], Newcastle Laryngeal Hypersensitivity Questionnaire [72], and Punum Ladder [39,78]. Supplementary table 3 lists the characteristics of these PROMs.…”

Section: Resultsmentioning

confidence: 99%

“…We strove for conceptual clarity by excluding domains or items related to cough impact on quality of life. Several validated and widely available PROMs already assess the impact of cough symptoms on quality of life, including the LCQ [7], CCIQ [8], CQLQ [9], COAT [10], and CET [11]. Our conceptual framework defines concepts to measure symptom severity, which would inform an instrument complementary to existing quality of life questionnaires.…”

Section: Findings In Context Of Other Studiesmentioning

confidence: 99%

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Cough symptom severity in patients with refractory or unexplained chronic cough: a systematic survey and conceptual framework

et al. 2021

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BackgroundCough severity represents an important subjective endpoint in assessing the effectiveness of therapies for patients with chronic cough. Although cough-specific quality of life questionnaires exist, a widely available cough severity instrument with established measurement properties remains unavailable.AimsTo identify and summarise the results of studies reporting on the experience of patients with chronic cough and, in the process, develop a conceptual framework to inform development of a patient-reported outcome measurement (PROM) addressing cough severity.ResultsWe identified 61 eligible studies reporting on patient experience with chronic cough. Studies provided 82 potential items, of which 43 proved unique and relevant to cough severity. The urge-to-cough sensation and the cough symptom itself represented broad domains of cough severity. Two subdomains under urge-to-cough included frequency (1 item) and intensity (1 item). Five subdomains under cough symptoms included control (2 items), frequency (6 items), bout duration (1 item), intensity (8 items), and associated features/sequelae (24 items).ConclusionsOur systematic survey and conceptual framework identified items and domains of cough severity in patients with refractory or unexplained chronic cough. The results support item generation and content validity for a PROM assessing cough severity.

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Section: Resultsmentioning

confidence: 99%

Section: Findings In Context Of Other Studiesmentioning

confidence: 99%

Cough symptom severity in patients with refractory or unexplained chronic cough: a systematic survey and conceptual framework

et al. 2021

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“…The cough VAS is a 100-mm scale on which the patients indicated the severity of cough. CET is a validated 5-item test to evaluate the full impact of chronic cough with regard to physical, social, and psychological aspects (17). Cough-related quality of life was assessed by LCQ that contained 19 items divided into three domains (physical, psychological, and social) (18).…”

Section: Assessmentmentioning

confidence: 99%

Clinical and Inflammatory Characteristics of the Chinese APAC Cough Variant Asthma Cohort

Lai

Zhan

et al. 2022

Front. Med.

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BackgroundThe AtyPical Asthma in China (APAC) cohort is a multi-center prospective, observational cohort set-up to investigate the clinical, pathophysiological features, prognosis, and mechanisms of cough variant asthma (CVA).ObjectivesTo present the characteristics of newly physician-diagnosed adults with CVA (n = 328) compared to mild-moderate classic asthma (CA, n = 206).Methods and Main ResultsCVA subjects showed a higher proportion of female (67.1 vs. 55.3%, P = 0.0084), abnormal laryngopharyngeal sensations (71 vs. 51%, p < 0.0001) than CA, but presented with near normal spirometry and higher methacholine PD20-FEV1 values [4.2 (1, 8.6) vs. 0.8 (0.4, 4.7), P < 0.0001]. Lower fractional exhaled nitric oxide (FENO) levels [38.5 (19.8, 72.5) vs. 53. (28.5, 92.2), P = 0.0019], blood eosinophil counts [0.2 (0.1, 0.4) vs. 0.3 (0.2, 0.5), P = 0.0014], and sputum eosinophils [2.3 (0.3, 8.0) vs. 12.2 (2, 34.5), p < 0.0001] were found in CVA. Despite lower total serum IgE levels in CVA, there was similar proportion of atopy in both groups. The prevalence of cough in CA was 86.4%, while CVA reported more severe cough on Visual Analog Scale, Cough Evaluation Test, and Leicester Cough Questionnaire, similar anxiety and depression scores but better asthma control scores as reflected by Asthma Control Test compared to CA. No correlation was found between cough assessment outcomes and sputum eosinophil count, blood eosinophil count, FENO, spirometry variables, or PD20-FEV1.ConclusionCough variant asthma is distinctive from classic asthma in regard to clinical features, lung function, and airway inflammation. Quality of life is badly impaired as well in spite of better asthma control scores.

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“…The test–retest reliability for cough severity VAS in this analysis (ICCs of 0.45–0.51) was found to be moderate compared with that of previous studies of other cough-related measures (ICCs of 0.68–0.96). 20 , 22 , 33 , 34 This finding was anticipated on the basis of the long duration between test periods (i.e., 4 weeks, compared with 1 to 2 weeks in previous studies), as well as the lack of a gold standard for defining a “stable” population. Although defining stability using an objective measure of awake cough frequency was considered a reasonable approach in this study, strong reliability estimates were not expected because of differences in the concepts measured with these outcomes (i.e., cough frequency vs. perceived cough severity) and previous reports of a lack of a strong correlation between cough frequency and cough-related PROs.…”

Section: Discussionmentioning

confidence: 89%

Validation of a visual analog scale for assessing cough severity in patients with chronic cough

Nguyen

Bacci

Vernon

et al. 2021

Ther Adv Respir Dis

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Introduction: Patients with chronic cough experience considerable burden. The cough severity visual analog scale (VAS) records patients’ assessment of cough severity on a 100-mm linear scale ranging from “no cough” (0 mm) to “worst cough” (100 mm). Although cough severity scales are widely used in clinical practice and research, their use in patients with refractory or unexplained chronic cough has not been formally validated. Methods: This analysis includes data from a phase 2b randomized controlled trial of the P2X3-receptor antagonist gefapixant for treatment of refractory or unexplained chronic cough (NCT02612610). Cough severity VAS scores were assessed at baseline and Weeks 4, 8, and 12. The cough severity VAS was validated using several outcomes, including the Cough Severity Diary (CSD), Leicester Cough Questionnaire (LCQ), patient global impression of change (PGIC) scale, and objective cough frequency. Validation metrics included test–retest reliability, convergent and known-groups validity, responsiveness, and score interpretation (i.e., clinically meaningful change threshold). Results: The analysis included 253 patients (median age, 61.0 years; females, 76%). Test–retest reliability of the cough severity VAS was moderate (intraclass correlation coefficient, 0.51). The cough severity VAS had acceptable convergent validity with other related measures (Pearson r of 0.53 and -0.41 for CSD and LCQ total scores, respectively; p < 0.0001 for each). Known-groups validity was supported by significant differences in mean cough severity VAS scores across severity groups defined using CSD, LCQ, and cough frequency tertiles. A large effect size was observed in patients with the greatest improvements in PGIC (Cohen d = -1.8). A ⩾ 30-mm reduction in the cough severity VAS was estimated as a clinically meaningful change threshold for clinical trials in chronic cough. Conclusions: The cough severity VAS is a valid and responsive measure. A cough severity VAS reduction of ⩾ 30 mm can discriminate clinically meaningful changes in chronic cough severity in clinical studies.

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A new simple score of chronic cough: cough evaluation test

Cited by 21 publications

References 26 publications

Cough symptom severity in patients with refractory or unexplained chronic cough: a systematic survey and conceptual framework

Cough symptom severity in patients with refractory or unexplained chronic cough: a systematic survey and conceptual framework

Clinical and Inflammatory Characteristics of the Chinese APAC Cough Variant Asthma Cohort

Validation of a visual analog scale for assessing cough severity in patients with chronic cough

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