Validation Approaches for Cough Monitoring Tools: A Scoping Review
Laylaa Ramos Arriaza1, Laurie Slovarp2, Brandon D Abell3
1Department of Otolaryngology-Head & Neck Surgery, University of Colorado Anschutz , 12631 E. 17th Avenue, Aurora, CO, 80045, USA.
Lung
|June 27, 2026
Summary
Validation methods for ambulatory cough monitoring systems are inconsistent, hindering clinical use. Standardization of protocols and real-world testing are crucial for advancing cough detection technology.
Area of Science:
- Medical Informatics
- Respiratory Medicine
- Biomedical Engineering
Background:
- Ambulatory cough monitoring systems are increasingly used in clinical and research settings.
- Variability in validation approaches may limit the reliability and applicability of these systems.
Purpose of the Study:
- To characterize the diverse validation methodologies employed in ambulatory cough monitoring.
- To identify methodological inconsistencies that impede the clinical and research utility of these technologies.
Main Methods:
- A comprehensive scoping review following PRISMA-ScR guidelines was conducted.
- Searches were performed in Embase, including English-language, peer-reviewed human studies.
- Data extraction and descriptive synthesis were performed on 50 included studies.
Main Results:
- Validation approaches were highly heterogeneous, with manual human annotation (66%) being the most common reference standard.
- Definitions of cough events and outcome metrics varied widely across studies.
- While systems showed high accuracy in controlled settings, real-world performance was variable, especially with background noise.
Conclusions:
- A standardized framework for reference measures and outcome metrics in cough monitoring validation is lacking.
- Manual annotation methods and cough event definitions require standardization.
- Development of shared datasets and real-world testing are essential for clinical translation.
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