title: Symptomatic Treatment of Cough Among Adult Patients With Lung Cancer: CHEST Guideline and Expert Panel Report.
abstract: BACKGROUND
  Cough among patients with lung cancer is a common but often undertreated symptom. We used a 2015 Cochrane systematic review, among other sources of evidence, to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.
  
  
  METHODS
  The CHEST methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework were used. The Expert Cough Panel based their recommendations on data from the Cochrane systematic review on the topic, uncontrolled studies, case studies, and the clinical context. Final grading was reached by consensus according to the Delphi method.
  
  
  RESULTS
  The Cochrane systematic review identified 17 trials of primarily low-quality evidence. Such evidence was related to both nonpharmacologic (cough suppression) and pharmacologic (demulcents, opioids, peripherally acting antitussives, or local anesthetics) treatments, as well as endobronchial brachytherapy.
  
  
  CONCLUSIONS
  Compared with the 2006 CHEST Cough Guideline, the current recommendations and suggestions are more specific and follow a step-up approach to the management of cough among patients with lung cancer, acknowledging the low-quality evidence in the field and the urgent need to develop more effective, evidence-based interventions through high-quality research.
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China. Electronic address: alex.molasiotis@polyu.edu.hk.
authors.forename: Alex
authors.initials: A
authors.lastname: Molassiotis
authors.affiliation: Centre for Respiratory Medicine and Allergy, University of Manchester and University Hospital of South Manchester, Manchester, England.
authors.forename: Jaclyn A
authors.initials: JA
authors.lastname: Smith
authors.affiliation: Respiratory Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Peter
authors.initials: P
authors.lastname: Mazzone
authors.affiliation: Department of Medical Oncology, Christie Hospital NHS Trust, Manchester, England.
authors.forename: Fiona
authors.initials: F
authors.lastname: Blackhall
authors.affiliation: University of Massachusetts Medical School, Worcester, MA.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Irwin
mesh_terms: D000328:Adult; D003371:Cough / Q000209:etiology* / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*
keywords: cough; evidence-based medicine; guidelines; lung cancer