title: Concordance and discriminatory power of cough measurement devices for individuals with Parkinson disease.
abstract: BACKGROUND
  Dysphagia and aspiration pneumonia are two causes of morbidity in Parkinson disease (PD). In PD, impaired airway clearance can lead to penetration of foreign material, resulting in a high prevalence of aspiration pneumonia and death. This study examines three different devices for measurement of peak airflow during voluntary cough in healthy control subjects and those with PD. Two simple and low-cost devices for measuring peak cough airflow were compared with the "gold standard" pneumotachograph.
  
  
  METHODS
  Thirty-five healthy control subjects and 35 individuals with PD produced voluntary cough at three perceived strengths (weak, moderate, and strong cough) for each of the three devices.
  
  
  RESULTS
  A significant difference in mean peak cough airflow was demonstrated for disease (F[1,56] = 4.0, P &lt; .05) and sex (F[1,56] = 9.59, P &lt; .003) across devices. The digital and analog meters were comparable to the gold standard demonstrating no significant difference (statistical) by device (digital vs analog) in receiver operating characteristic curve analysis. Both devices were discriminative of the presence of PD.
  
  
  CONCLUSIONS
  The analog and digital peak airflow meters are suitable alternatives to the gold standard pneumotachograph due to their low cost, portability, ease of use, and high sensitivity relative to normative peak cough airflows. Voluntary cough airflow measures may serve as a noninvasive means of screening for aspiration risk in target populations. Additionally, quantification of cough strength through use of predetermined limens for weak, moderate, and strong cough may assist clinicians in better describing and tracking cough strength as a contributing factor to aspiration risk.
authors.affiliation: Brain Rehabilitation and Research Center, Malcom Randall VA Medical Center, Gainesville; Department of Physiological Sciences, Center for Movements Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville. Electronic address: epearson@ufl.edu.
authors.forename: Erin P
authors.initials: EP
authors.lastname: Silverman
authors.affiliation: College of Veterinary Medicine, Department of Behavioral Science and Community Health, Center for Movements Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville.
authors.forename: Giselle
authors.initials: G
authors.lastname: Carnaby-Mann
authors.affiliation: Department of Physiological Sciences, Center for Movements Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pitts
authors.affiliation: Department of Physiological Sciences, Center for Movements Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville.
authors.forename: Paul
authors.initials: P
authors.lastname: Davenport
authors.affiliation: College of Public Health and Health Professions, and Departments of Neurology and Neurosurgery, Center for Movements Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
authors.affiliation: Department of Physiological Sciences, Center for Movements Disorders and Neurorestoration, College of Medicine, University of Florida, Gainesville; Department of Communication Sciences and Disorders, College of Health Sciences, Jacksonville University, Jacksonville, FL.
authors.forename: Christine
authors.initials: C
authors.lastname: Sapienza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003371:Cough / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000150:complications* / Q000503:physiopathology; D003948:Diagnostic Techniques, Respiratory System / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D012372:ROC Curve; D015203:Reproducibility of Results