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Validation of cough evaluation test in subacute cough
Jianyi Li1, Yuling Li1,2, Wenzhi Zhan1
1Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Background:
Cough evaluation test (CET) is a simple and effective subjective tool designed to evaluate physical, psychological and social impact of chronic cough. However, it has not been validated in subacute cough. This study aims to evaluate the reliability, validity, and responsiveness of CET in patients with subacute cough.
Methods:
A total of 158 patients with subacute cough were recruited from the outpatient department of The First Affiliated Hospital of Guangzhou Medical University between November 2022 and March 2024. All patients provided demographic information and completed CET, cough severity Visual Analogue Scale (VAS), Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC) and Cough Symptom Score (CSS) at baseline. Sixty-five patients were followed up via telephone after 7 days, and finished CET, VAS, CSS and Global Rating of Change Questionnaire. Internal consistency, item analysis, concurrent validity, repeatability, responsiveness and minimal important clinical difference were evaluated.
Results:
Among all 158 patients, the median age and cough duration were 36.0 (30.0, 49.0) years and 4.0 (4.0, 6.0) weeks, respectively, and 56.3% were female. CET demonstrated good internal consistency (Cronbach's alpha =0.805). It showed moderate to strong correlations with VAS (r=0.662), LCQ-MC (r=-0.732), CSS total (r=0.672), CSS daytime (r=0.558) and CSS nighttime (r=0.509). VAS exhibited a stronger correlation with CET than with LCQ-MC and CSS nighttime (both P<0.001). Moreover, correlation between LCQ-MC and CET was higher than that between LCQ-MC and VAS/CSS total/CSS daytime/CSS nighttime (all P<0.001). Despite slight changes in cough condition, the intraclass correlation coefficient for CET was 0.571 (P<0.001). CET significantly decreased from 15.0 (13.0, 17.0) at baseline to 9.0 (7.0, 12.0) at follow-up. Minimal important clinical difference of CET was 2.0 (1.0, 5.0).
Conclusions:
CET is a reliable, valid and responsive subjective tool for assessing subacute cough. CET could evaluate multidimensional impact of cough in a simpler and quicker way, which contributes to the cough assessment in clinics and researches.
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