Prevalence and Burden of Chronic Cough in the United States

Meltzer, Eli O.; Zeiger, Robert S.; Dicpinigaitis, Peter V.; Bernstein, Jonathan A.; Oppenheimer, John; Way, Nate; Li, Vicky W.; Boggs, Robert; Doane, Michael J.; Urdaneta, Elena; Weaver, Jessica; Schelfhout, Jonathan; Fonseca, Eileen

doi:10.1016/j.jaip.2021.07.022

Cited by 60 publications

(73 citation statements)

References 34 publications

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“…In this study, the weighted prevalence of lifetime and 12-month CC was 8.2% and 5.5% respectively. These figures are in line with recently published NHWS surveys from the USA 24 and Japan 25 using similar methodology, which reported a weighted prevalence of 12-month CC of 5.0% 24 and 4.3%, 25 respectively.…”

Section: Discussionsupporting

confidence: 91%

Prevalence of chronic cough and patient characteristics in adults in Spain: A population-based cross-sectional survey

Domínguez‐Ortega

Plaza

et al. 2022

Chron Respir Dis

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Background Chronic cough (CC) represents a significant health burden. This study assessed the prevalence of CC (defined as per international guidelines as cough duration >8 weeks) in Spanish adults and compared characteristics between CC and non-CC cohorts. Methods CC cohorts were compiled using data from adult respondents to the 2020 Spanish cross-sectional online National Health and Wellness Survey (NHWS). Using propensity scores, respondents experiencing CC during their lifetime and the previous 12 months were matched 3:1 to respondents without CC and their health characteristics were compared. The number of Spanish adults affected with CC was estimated using weighted CC prevalence. Results CC during their lifetime or the previous 12 months was experienced by 579 (8.2%) and 389 (5.5%) of 7074 NHWS respondents, of whom 233 (38.5%) and 171 (44.0%), respectively, had physician-diagnosed CC. Based on weighted prevalence rates, lifetime and 12-month CC were estimated to affect ≈3.3 million and ≈2.2 million Spanish adults, respectively. Relative to the non-CC cohort, the 12-month CC cohort consistently demonstrated poorer health status, poorer mental health, greater healthcare utilization, and lower productivity at work and home. Conclusion This study contributes novel data regarding the prevalence of CC in Spain, suggests that CC is underdiagnosed, and reflects that CC and related comorbidities inflict a significant health burden in the affected population.

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Section: Discussionsupporting

confidence: 91%

Prevalence of chronic cough and patient characteristics in adults in Spain: A population-based cross-sectional survey

Domínguez‐Ortega

Plaza

et al. 2022

Chron Respir Dis

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“…Chronic cough, as identified by our model, was present in 1.5% of the sample population. This is lower than previous prevalence estimates of ~ 5% from general population surveys, but similar to the 1.04% prevalence reported in our previous work on NLP-mediated identification of CC from administrative data [ 6 , 7 , 20 ]. The generalizability of our sample population to the overall US population is unknown.…”

Section: Discussionsupporting

confidence: 82%

Development of a natural language processing algorithm to detect chronic cough in electronic health records

et al. 2022

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Background Chronic cough (CC) is difficult to identify in electronic health records (EHRs) due to the lack of specific diagnostic codes. We developed a natural language processing (NLP) model to identify cough in free-text provider notes in EHRs from multiple health care providers with the objective of using the model in a rules-based CC algorithm to identify individuals with CC from EHRs and to describe the demographic and clinical characteristics of individuals with CC. Methods This was a retrospective observational study of enrollees in Optum’s Integrated Clinical + Claims Database. Participants were 18–85 years of age with medical and pharmacy health insurance coverage between January 2016 and March 2017. A labeled reference standard data set was constructed by manually annotating 1000 randomly selected provider notes from the EHRs of enrollees with ≥ 1 cough mention. An NLP model was developed to extract positive or negated cough contexts. NLP, cough diagnosis and medications identified cough encounters. Patients with ≥ 3 encounters spanning at least 56 days within 120 days were defined as having CC. Results The positive predictive value and sensitivity of the NLP algorithm were 0.96 and 0.68, respectively, for positive cough contexts, and 0.96 and 0.84, respectively, for negated cough contexts. Among the 4818 individuals identified as having CC, 37% were identified using NLP-identified cough mentions in provider notes alone, 16% by diagnosis codes and/or written medication orders, and 47% through a combination of provider notes and diagnosis codes/medications. Chronic cough patients were, on average, 61.0 years and 67.0% were female. The most prevalent comorbidities were respiratory infections (75%) and other lower respiratory disease (82%). Conclusions Our EHR-based algorithm integrating NLP methodology with structured fields was able to identify a CC population. Machine learning based approaches can therefore aid in patient selection for future CC research studies.

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“…A Canadian study showed in subjects aged 45 to 85 years self-reported prevalence of CC (coughed most days in the previous 12 months) was 15.8% at baseline and 17.1% at 3-year follow-up [ 28 ]. In the US, based on 75 000 National Health and Wellness Survey adult (≥18 years) respondents, 5.0% had experienced CC (daily cough at least 8 weeks) in the previous 12 months [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic cough in Germany: results from a general-population survey

Virchow

Fonseca

et al. 2021

ERJ Open Res

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BackgroundChronic cough (CC) which is defined≥8 weeks is a common condition in clinical practice. However, estimates of prevalence and associated comorbidities in German adults and key subgroups of age and gender are lacking.MethodsCross-sectional study based on a representative panel of 15,020 adult subjects of the general population who completed the German National Health and Wellness Survey, reporting chronic cough and questions about comorbidities. Lifetime and 12-month prevalence are presented as unweighted estimates.ResultsThe lifetime CC prevalence was 6.5% (range across age groups, 5.1%–8.3%) and the 12-month prevalence was 4.9% (range 3.7–5.7%). The prevalence of diagnosed CC was 2.8% (range, 0.9–4.1%) and the prevalence of persons currently on any prescription to treat CC was 0.6% (range 0.2–1.4%). Respondents who experienced CC were 52.0±17.0 years old, with a higher prevalence in those aged 50 years and older. Persons with CC had higher morbidity scores and were diagnosed with an increased number of comorbidities, most frequently diagnoses of the respiratory system (71.0%), followed by digestive tract (34.0%) disorders and sleep disorders (37.6%).ConclusionsIn a broadly representative sample of German adults, lifetime and 12-month prevalence of CC was greatest in current and former smokers and those older≥50 years of age. Comorbidities are frequent and may complicate management of these patients.

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Prevalence and Burden of Chronic Cough in the United States

Cited by 60 publications

References 34 publications

Prevalence of chronic cough and patient characteristics in adults in Spain: A population-based cross-sectional survey

Prevalence of chronic cough and patient characteristics in adults in Spain: A population-based cross-sectional survey

Development of a natural language processing algorithm to detect chronic cough in electronic health records

Chronic cough in Germany: results from a general-population survey

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