Subjective scoring of cough in children: parent-completed vs child-completed diary cards vs an objective method

Abstract

Cough is often used as an outcome measure, although the reporting of cough is unreliable. Using a 24 h ambulatory cough meter to measure cough frequency, the aim of this study was to compare: 1) the correlation of child-completed diary cards to the objective measurement, with that of parent-completed diary cards; and 2) the visual analogue scale (VAS) to the verbal category descriptive (VCD) score. The cough meter consisted of a previously validated Holter monitor and a cough processor. Eighty four children (39 with recurrent cough and 45 controls, aged 6-17 yrs) used a cough meter at least once. Thirty three subjects used the cough meter twice. Parents and children completed separate diary cards using the VAS and VCD scores. The strength of the relationship between the subjective scores and the objective recordings was analysed by spearman's rank correlation coefficient. For daytime cough, child-completed diary cards and the VCD correlated better to the objective measurement than parent-completed diary cards and the VAS, respectively. In subjects that used the cough meter twice, the difference between the cough frequency correlated to the difference in the subjective scores. The confidence intervals for the correlation coefficients were wide. The agreement between the objective and subjective presence of daytime cough was good but that for night-time cough was poor. We conclude that the severity of cough defined on diary cards may not represent cough frequency. Objective readings are first choice but currently not yet practical. The verbal category descriptive diary card completed by children and assisted by parents has the highest correlation to cough frequency measured objectively.

Effect of Dextromethorphan, Diphenhydramine, and Placebo on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents

“…9,18 That noted, subjective reporting of cough by children and their parents has been shown to be imprecise. [33][34][35][36][37][38] These studies, however, were performed on children with chronic cough, asthma, or cystic fibrosis as opposed to the acute cough that was evaluated in this study. In addition, in this investigation, each parent served as his or her own control, because their answers were compared with their own responses from the previous night.…”

Utility of signs and symptoms of chronic cough in predicting specific cause in children

“…The detailed protocol, investigations used, and number of abnormal results have been published elsewhere. 14 A validated cough diary 15 was completed by each patient (or caregiver) throughout the duration of the study to assess response to treatment. Diagnostic categories were reached using standard a priori definitions which included investigation results and response to treatment.…”

“…Diagnostic categories were reached using standard a priori definitions which included investigation results and response to treatment. Response to treatment was defined as improvement by .75% according to cough diary data 15 or total resolution of the cough. The primary diagnostic outcome was defined as the diagnosis (and subsequent treatment) which resulted in cough resolution.…”

Calcitonin gene-related peptide relates to cough sensitivity in children with chronic cough

“…Medical history was obtained from a parent on a standardised proforma for all children. Parent(s) also scored their child's cough on a validated cough visual analogue scale of 1 (no cough) to 10 (most severe cough) [24]. Exclusion criteria of children were as follows.…”