Use of management pathways or algorithms in children with chronic cough: Systematic Reviews
Author(s)
Chang, Anne B
Oppenheimer, John J
Weinberger, Miles
Weir, Kelly
Rubin, Bruce K
Irwin, Richard S
Griffith University Author(s)
Year published
2016
Metadata
Show full item recordAbstract
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
c ...
View more >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 ¼ 1; cohort studies ¼ 7) and eight in KQ3 (RCT ¼ 2; cohort ¼ 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.
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View more >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 ¼ 1; cohort studies ¼ 7) and eight in KQ3 (RCT ¼ 2; cohort ¼ 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.
View less >
Journal Title
Chest
Volume
149
Issue
1
Copyright Statement
Self-archiving of the author-manuscript version is not yet supported by this journal. Please refer to the journal link for access to the definitive, published version or contact the author[s] for more information.
Subject
Clinical sciences
Clinical sciences not elsewhere classified