Journal Reading 1

Classification of Cough As a
Symptom in
Adults and Management Algorithms
Richard S. Irwin, MD, Master FCCP; Cynthia L. French,
PhD, RN, ANP-BC, FCCP; Anne B. Chang, MBBS, PhD,
MPH;
Kenneth W. Altman, MD, PhD

chestjournal.org
 Introduction

Cough Classification Algorithms

2
• Cough is a common complaint that results in significant
morbidity and impairment in quality of life
• We used the CHEST Expert Cough Panel’s protocol for the
systematic reviews and the American College of Chest
Physicians (CHEST) methodological guidelines and Grading
of Recommendations Assessment, Development, and
Evaluation framework.

3
4
5
6
The consult question is: would this patient
benefit clinically by using 1 of these tests to
determine whether his dose of aspirin should
be modified?

7
8
9
10
11
12
 Suggestions
• For adult patients complaining of cough, we
suggest that acute cough be defined as being < 3
weeks in duration
• For adult patients complaining of cough, we
suggest that subacute cough be defined as being
between 3 and 8 weeks in duration
• For adult patients complaining of cough, we
suggest that chronic cough be defined as being >
8 weeks in duration

13
 Suggestions (2)
• For adult patients seeking medical care
complaining of cough, we suggest that estimating
the duration of cough is the first step in
narrowing the list of potential diagnoses
• For adult patients around the globe complaining
of cough, we suggest that the cough be managed
using evidence-based guidelines that are based
upon duration of cough

14
 Conclusions

Although the quality of evidence was low, the

published literature since 2006
suggests that CHEST’s 2006 Cough Guidelines
and management algorithms for acute,
subacute, and chronic cough in adults appeared
useful in diagnosing and treating patients
with cough around the globe. These same
algorithms have been updated to reflect the
advances in cough management as of 2017.
15
“Love and a cough cannot be hid”
-George Herbert-

THANK YOU
16
 Leicester Cough Questionnaire

• LCQ Scoring
1. Domains (questions):
Physical: 1,2,3,9,10,11,14,15
Psychological:4,5,6,12,13,16,17
Social: 7,8,18,19
2. Domain Scores: total score from items in domain
/ number of items in domain (range 1-7)
3. Total Scores: Addition of domain scores (range 3-
21)
17