학술논문

Validation and Meaningful Change Thresholds for an Objective Cough Frequency Measurement in Chronic Cough
Document Type
Academic Journal
Source
Lung. December, 2022, Vol. 200 Issue 6, p717, 8 p.
Subject
United States
New Jersey
United Kingdom
Language
English
ISSN
0341-2040
Abstract
Purpose Objective cough frequency is used to assess efficacy of chronic cough (CC) treatments. The objective of this study was to explore the relationship between objective cough frequency and cough-specific patient-reported outcomes (PROs) and estimate a clinically meaningful change threshold (MCT) for objective cough frequency. Methods Data collected in a phase 2b study in participants with refractory or unexplained CC were used to investigate the relationship between 24-h cough frequency (measured using an ambulatory cough monitor) and cough-specific PROs (i.e., cough severity visual analog scale, cough severity diary, Leicester Cough Questionnaire). Convergent validity was assessed using Spearman [rho]. An MCT for 24-h cough frequency was estimated using the patient global impression of change (PGIC) scale as an anchor. Results Correlations between 24-h cough frequency and cough-specific PROs at baseline, Week 4, and Week 12 were significant (P < 0.0001) but low to moderate in strength ([rho] = 0.30-0.58). Participants categorized as very much improved/much improved (i.e., PGIC of 1 or 2) or minimally improved (i.e., PGIC of 3) had mean 24-h cough frequency reductions of 55% and 30%, respectively. Receiver operating characteristic curve analysis suggested that a 24-h cough frequency reduction of 38% optimizes sensitivity and specificity for predicting a PGIC score of 1-3. Conclusion Objective 24-h cough frequency is significantly associated with cough-specific PROs, but cough frequency and PROs most likely capture distinct aspects of CC. A [greater than or equal to] 30% reduction in 24-h cough frequency is a reasonable MCT to define treatment response in CC clinical trials.
Author(s): Jonathan Schelfhout [sup.1], Allison Martin Nguyen [sup.1], Surinder S. Birring [sup.2], Elizabeth D. Bacci [sup.3], Margaret Vernon [sup.4], David R. Muccino [sup.1], Carmen La Rosa [sup.1], Jaclyn A. Smith [...]