KAAACI Consensus Document on the Goals and Standards of Chronic Cough Clinics in Korea: A Delphi Study

Specialist cough clinics operate in various countries to address the complex needs of patients with chronic cough. Despite their increasing recognition and the recent establishment of an international consensus, such as the European Respiratory Society NEUROCOUGH initiative, no formal agreement on the goals and standards of chronic cough clinics has been established in South Korea. To address this gap, the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI) and its Chronic Cough Working Group initiated a Delphi study to develop an expert consensus on the objectives, roles, and standards of chronic cough clinics tailored to the Korean healthcare context.

A Task Force endorsed by KAAACI and composed of members of the Chronic Cough Working Group conducted a 2-round Delphi survey involving 113 clinicians with relevant clinical or research expertise. The panel evaluated 12 statements and 17 diagnostic items. A consensus was defined as > 70% agreement and < 20% disagreement.

Consensus was achieved for all 12 statements (agreement rates, 93.9%-99%), covering clinical care, research, and education. The key agreements were the provision of evidence-based care to improve the quality of life and reduce disease burden; comprehensive assessment of cough characteristics and treatable traits; careful use of neuromodulators or opioid antitussives; appropriate referral to other specialists; and active participation in research and education. A minimum diagnostic test panel, comprising chest radiography, spirometry, paranasal sinus X-ray, and fractional exhaled nitric oxide measurement/blood eosinophil count, was also established.

This study presents the first national consensus to define the goals and standards of chronic cough clinics in South Korea. The recommendations reflect a balance between internationally suggested approaches and local healthcare realities. This consensus is expected to provide updates to national guidelines, facilitate standardized care, and support future research and educational initiatives in chronic cough.