title: The sensitivity of acoustic cough recording relative to intraesophageal pressure recording and patient report during reflux testing.
abstract: BACKGROUND
  One of the primary indications for reflux testing with multichannel intraluminal impedance with pH (pH-MII) is to correlate reflux events with symptoms such as cough. Adult and pediatric studies have shown, using cough as a model, that patient report of symptoms is inaccurate. Unfortunately, intraesophageal pressure recording (IEPR) to record coughs is more invasive which limits its utility in children. The primary aim of this study was to validate the use of acoustic cough recording (ACR) during pH-MII testing.
  
  
  METHODS
  We recruited children undergoing pH-MII testing for the evaluation of cough. We simultaneously placed IEPR and pH-MII catheters and an ACR device in each patient. Each 24 h ACR, pH-MII, and IEPR tracing was scored by blinded investigators. Sensitivities for each method of symptom recording were calculated.
  
  
  RESULTS
  A total of 2698 coughs were detected; 1140 were patient reported PR, 2425 were IEPR detected, and 2400 were ACR detected. The sensitivity of PR relative to ACR was 45.9% and the sensitivity of IEPR relative to ACR was 93.6%. There was strong inter-rater reliability (κ = 0.78) for the identification of cough by ACR.
  
  
  CONCLUSIONS
  Acoustic recording is a non-invasive, sensitive method of recording cough during pH-MII testing that is well suited for the pediatric population.
authors.affiliation: Division of Gastroenterology and Nutrition, Aerodigestive Center, Boston Children's Hospital, Boston, MA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Rosen
authors.forename: J
authors.initials: J
authors.lastname: Amirault
authors.forename: N
authors.initials: N
authors.lastname: Heinz
authors.forename: H
authors.initials: H
authors.lastname: Litman
authors.forename: U
authors.initials: U
authors.lastname: Khatwa
mesh_terms: D000162:Acoustics / Q000295:instrumentation; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000175:diagnosis / Q000209:etiology; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011312:Pressure; D012680:Sensitivity and Specificity
keywords: cough; gastroesophageal reflux; impedance