Evaluating cough assessment tools: a systematic review.
BACKGROUND
Little is known about the comparative validity, reliability, or responsiveness of instruments for assessing cough frequency or impact, where the term impact encompasses both cough severity and the impact of cough on health-related quality of life.


METHODS
We conducted a systematic review to evaluate instruments that assess cough frequency or impact in adults, adolescents, and children with acute or chronic cough.


RESULTS
Seventy-eight studies were included, of which eight were randomized controlled trials and 70 were observational studies. In all age groups, audio and video electronic recording devices had good reliability compared with other methods of assessing cough frequency but had variable correlation with other cough assessments, such as visual analog scale scores, quality-of-life questionnaires, cough diaries, and tussigenic challenges. Among adult and adolescent patients, the Leicester Cough Questionnaire (LCQ) and the Cough-Specific Quality-of-Life Questionnaire (CQLQ) were valid and reliable, showing high intraclass and test-retest correlations. Among children, the Parent Cough-Specific Quality of Life Questionnaire and Pediatric Cough Questionnaire were valid and reliable.


CONCLUSIONS
Electronic recording devices can be valid assessments of cough frequency. The LCQ and CQLQ for adults and the Parent Cough-Specific Quality of Life questionnaire for children are valid instruments for assessing cough impact. There is limited but insufficient evidence to determine the reliability or concurrent validity of the different types of cough diaries or visual analog scale scores. There are also limited data to support the responsiveness of recording devices. There is good responsiveness data for the LCQ and CQLQ, but more evidence is needed.
Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC. Electronic address: kristine.schmit@duke.edu.
Kristine M
KM
Schmit
Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, NC; Duke Evidence-based Practice Center, Duke Clinical Research Institute, Duke University, Durham, NC.
Remy R
RR
Coeytaux
Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, NC.
Adam P
AP
Goode
Department of Medicine, Duke University School of Medicine, Durham, NC; Duke Evidence-based Practice Center, Duke Clinical Research Institute, Duke University, Durham, NC; Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, Durham, NC.
Douglas C
DC
McCrory
Department of Medicine, Duke University School of Medicine, Durham, NC; Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, Durham, NC.
William S
WS
Yancy
Department of Pediatrics, Duke University School of Medicine, Durham, NC.
Alex R
AR
Kemper
Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC.
Vic
V
Hasselblad
Duke Evidence-based Practice Center, Duke Clinical Research Institute, Duke University, Durham, NC.
Brooke L
BL
Heidenfelder
Department of Medicine, Duke University School of Medicine, Durham, NC; Duke Evidence-based Practice Center, Duke Clinical Research Institute, Duke University, Durham, NC.
Gillian D
GD
Sanders
D000293:Adolescent; D000328:Adult; D002648:Child; D003371:Cough / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000379:methods*; D013637:Tape Recording; D064232:Visual Analog Scale; D055815:Young Adult