Anne B Chang1, John J Oppenheimer2, Miles Weinberger3, Kelly Weir4, Bruce K Rubin5, Richard S Irwin6. 1. Menzies School of Health Research; and Respiratory Deptartment, Lady Cilento Children's Hospital, Queensland University of Technology, Queensland, Australia. Electronic address: annechang@ausdoctors.net. 2. Division of Allergy and Immunology, UMDNJ-New Jersey Medical School, Cedar Knolls, NJ. 3. Pediatric Allergy, Immunology, and Pulmonology Division, University of Iowa Children's Hospital, Iowa City, IA. 4. Speech Pathology Deptartment, Lady Cilento Children's Hospital, Brisbane, Australia. 5. Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA. 6. Division of Pulmonary, Allergy & Critical Care Medicine, UMass Memorial Medical Center, Worcester, MA.
Abstract
BACKGROUND: Use of appropriate cough pathways or algorithms may reduce the morbidity of chronic cough, lead to earlier diagnosis of chronic underlying illness, and reduce unnecessary costs and medications. We undertook three systematic reviews to examine three related key questions (KQ): In children aged ?14 years with chronic cough (> 4 weeks' duration), KQ1, do cough management protocols (or algorithms) improve clinical outcomes? KQ2, should the cough management or testing algorithm differ depending on the duration and/or severity? KQ3, should the cough management or testing algorithm differ depending on the associated characteristics of the cough and clinical history? METHODS: We used the CHEST expert cough panel's protocol. Two authors screened searches and selected and extracted data. Only systematic reviews, randomized controlled trials (RCTs), and cohort studies published in English were included. RESULTS: Data were presented in Preferred Reporting Items for Systematic Reviews and Meta-analyses flowcharts and summary tabulated. Nine studies were included in KQ1 (RCT = 1; cohort studies = 7) and eight in KQ3 (RCT = 2; cohort = 6), but none in KQ2. CONCLUSIONS: There is high-quality evidence that in children aged ?14 years with chronic cough (> 4 weeks' duration), the use of cough management protocols (or algorithms) improves clinical outcomes and cough management or the testing algorithm should differ depending on the associated characteristics of the cough and clinical history. It remains uncertain whether the management or testing algorithm should depend on the duration or severity of chronic cough. Pending new data, chronic cough in children should be defined as > 4 weeks' duration and children should be systematically evaluated with treatment targeted to the underlying cause irrespective of the cough severity.
BACKGROUND: Use of appropriate cough pathways or algorithms may reduce the morbidity of chronic cough, lead to earlier diagnosis of chronic underlying illness, and reduce unnecessary costs and medications. We undertook three systematic reviews to examine three related key questions (KQ): In children aged ?14 years with chronic cough (> 4 weeks' duration), KQ1, do cough management protocols (or algorithms) improve clinical outcomes? KQ2, should the cough management or testing algorithm differ depending on the duration and/or severity? KQ3, should the cough management or testing algorithm differ depending on the associated characteristics of the cough and clinical history? METHODS: We used the CHEST expert cough panel's protocol. Two authors screened searches and selected and extracted data. Only systematic reviews, randomized controlled trials (RCTs), and cohort studies published in English were included. RESULTS: Data were presented in Preferred Reporting Items for Systematic Reviews and Meta-analyses flowcharts and summary tabulated. Nine studies were included in KQ1 (RCT = 1; cohort studies = 7) and eight in KQ3 (RCT = 2; cohort = 6), but none in KQ2. CONCLUSIONS: There is high-quality evidence that in children aged ?14 years with chronic cough (> 4 weeks' duration), the use of cough management protocols (or algorithms) improves clinical outcomes and cough management or the testing algorithm should differ depending on the associated characteristics of the cough and clinical history. It remains uncertain whether the management or testing algorithm should depend on the duration or severity of chronic cough. Pending new data, chronic cough in children should be defined as > 4 weeks' duration and children should be systematically evaluated with treatment targeted to the underlying cause irrespective of the cough severity.
Authors: Anne B Chang; John J Oppenheimer; Peter J Kahrilas; Ahmad Kantar; Bruce K Rubin; Miles Weinberger; Richard S Irwin Journal: Chest Date: 2019-04-16 Impact factor: 9.410
Authors: Anne B Chang; John J Oppenheimer; Miles Weinberger; Cameron C Grant; Bruce K Rubin; Richard S Irwin Journal: Chest Date: 2017-06-21 Impact factor: 9.410
Authors: Kian Fan Chung; Lorcan McGarvey; Woo-Jung Song; Anne B Chang; Kefang Lai; Brendan J Canning; Surinder S Birring; Jaclyn A Smith; Stuart B Mazzone Journal: Nat Rev Dis Primers Date: 2022-06-30 Impact factor: 65.038
Authors: Ahmad Kantar; Anne B Chang; Mike D Shields; Julie M Marchant; Keith Grimwood; Jonathan Grigg; Kostas N Priftis; Renato Cutrera; Fabio Midulla; Paul L P Brand; Mark L Everard Journal: Eur Respir J Date: 2017-08-24 Impact factor: 16.671
Authors: Kerry K Hall; Anne B Chang; Jennie Anderson; Daniel Arnold; Vikas Goyal; Melissa Dunbar; Michael Otim; Kerry-Ann F O'Grady Journal: Front Pediatr Date: 2017-10-31 Impact factor: 3.418
Authors: Alessandro Zanasi; Luigi Morcaldi; Salvatore Cazzato; Massimiliano Mazzolini; Marzia Lecchi; Antonio Maria Morselli-Labate; Marianna Mastroroberto; Roberto W Dal Negro Journal: Clinicoecon Outcomes Res Date: 2017-03-16