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Related Experiment Video

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Methods for Detecting Cough and Airway Inflammation in Mice
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ACR Appropriateness Criteria® Chronic Cough.

, Christopher T Kuzniewski1, Oskar Kizhner2

  • 1Naval Medical Center Portsmouth, Portsmouth, Virginia.

Journal of the American College of Radiology : JACR
|November 19, 2021
PubMed
Summary

Chronic cough, lasting over 8 weeks, has many causes and can be challenging to diagnose. The American College of Radiology Appropriateness Criteria offer evidence-based guidelines for imaging in chronic cough evaluation.

Keywords:
AUCAppropriate Use CriteriaAppropriateness CriteriaCTChest radiographChronic coughPersistent coughRefractory cough

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Area of Science:

  • Pulmonology
  • Radiology
  • Evidence-based Medicine

Background:

  • Chronic cough, defined as lasting at least 8 weeks, presents diagnostic challenges due to multifactorial etiologies including smoking-related lung disease, upper airway cough syndrome, asthma, and gastroesophageal reflux disease.
  • The complex pathophysiology and variable clinical presentations of chronic cough necessitate a structured approach to evaluation and management.
  • Current evidence guiding the use and timing of imaging modalities in chronic cough assessment is limited, highlighting a need for evidence-based recommendations.

Framework:

  • The American College of Radiology Appropriateness Criteria provide evidence-based guidelines for medical imaging in specific clinical conditions.
  • These guidelines are developed and revised annually by a multidisciplinary expert panel, involving extensive literature analysis.
  • Methodologies such as the RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) are employed to rate the appropriateness of imaging procedures.

Implementation:

  • Imaging plays a role in the initial evaluation of chronic cough, but optimal utilization requires clear guidance.
  • The Appropriateness Criteria aim to standardize and optimize the use of imaging in the diagnostic workup of chronic cough.
  • Expert opinion may supplement evidence in cases where data is lacking or equivocal to guide imaging decisions.

Implications:

  • These evidence-based guidelines can assist clinicians in making informed decisions regarding imaging for patients with chronic cough.
  • Standardized imaging protocols may improve diagnostic accuracy and patient outcomes for chronic cough.
  • Further research is needed to strengthen the evidence base for imaging in chronic cough evaluation.