TY - JOUR
T1 - Can acute cough characteristics from sound recordings differentiate common respiratory illnesses in children?
T2 - A comparative prospective study
AU - Bisballe-Müller, Nina
AU - Chang, Anne B
AU - Plumb, Erin J
AU - Oguoma, Victor M
AU - Halken, Susanne
AU - McCallum, Gabrielle B
N1 - Funding Information:
Financial/nonfinancial disclosures: The authors have reported to CHEST the following: G. B. M. is funded by an NHMRC early career fellowship (grant 1111705). A. B. C. is supported by a NHMRC practitioner fellowship (APP1154302) and Children’s Hospital Foundation Queensland (grant 50286) None declared (N. B. M., E. J. P., V. M. O., S. H.).
Funding Information:
Author contributions: A. B. C. conceived the study, and G. B. M. and A. B. C. participated in the study design. E. J. P. developed the protocol, data collection forms, and database under the supervision of G. B. M. and actively recruited participants. N. B. M. actively recruited participants. G. B. M. supported the coordination of the study from inception to analysis and manuscript preparation. N. B. M. had full access to the raw data and conducted the statistical analysis with support from V. M. O. supervised by G. M. B. and A. B. C. S. H. contributed to the interpretation and the discussion of the results. N. B. M. drafted the initial manuscript with substantial revisions undertaken by G. B. M. and A. B. C. All authors contributed to editing the manuscript and approved the final version. Financial/nonfinancial disclosures: The authors have reported to CHEST the following: G. B. M. is funded by an NHMRC early career fellowship (grant 1111705). A. B. C. is supported by a NHMRC practitioner fellowship (APP1154302) and Children's Hospital Foundation Queensland (grant 50286) None declared (N. B. M. E. J. P. V. M. O. S. H.). Other contributions: The authors are grateful to all participants and caregivers who participated in the study, and to research nurses Francisca Tenorio, Cate Wilson, and Lesley Versteegh for their help with data collection. Additional information: The e-Tables can be found in the Supplemental Materials section of the online article.
Publisher Copyright:
© 2020 American College of Chest Physicians
PY - 2021/1
Y1 - 2021/1
N2 - BACKGROUND: Acute respiratory illnesses cause substantial morbidity worldwide. Cough is a common symptom in these childhood respiratory illnesses but there is currently no large cohort data on whether various cough characteristics can differentiate between these aetiologies.RESEARCH QUESTION: Can various clinically-based cough characteristics (frequency [day-time/ night-time], the sound itself, or type [wet/dry]) be used to differentiate common aetiologies (asthma, bronchiolitis, pneumonia, other acute respiratory infections) of acute cough in children?STUDY DESIGN AND METHODS: Between 2017-2019, children aged 2-weeks to ≤16-years hospitalised with asthma, bronchiolitis, pneumonia, other acute respiratory infections, or controls were enrolled. Spontaneous coughs were digitally recorded over 24-hours except for the controls, who provided three voluntary coughs. Coughs were extracted and frequency defined (coughs/hour). Cough sounds and type were assessed independently by two observers blinded to the clinical data. Cough scored by a respiratory specialist was compared to discharge diagnosis using agreement (Cohen's kappa coefficient [қ]), sensitivity, and specificity. Caregiver reported cough scores were related with objective cough frequency using Spearman's coefficient (rs).RESULTS: A cohort of 148 children (n=118 with respiratory illnesses, n=30 controls), median age=2.0 years (interquartile range 0.7, 3.9), 58% males, and 50% First Nations children were enrolled. In those with respiratory illnesses, caregiver reported cough scores and wet cough (range 42-63%) was similar. Overall agreement in diagnosis between the respiratory specialist and discharge diagnosis was slight (қ=0.13, 95%CI 0.03, 0.22). Among diagnoses, specificity (8-74%) and sensitivity (53-100%) varied. Inter-rater agreement in cough type (wet/dry) between blinded observers was almost perfect (қ=0.89, 95%CI 0.81, 0.97). Objective cough frequency was significantly correlated with reported cough scores using visual analogue scale (rs=0.43, bias-corrected 95%CI 0.25, 0.56) and verbal categorical description day-time score (rs=0.39, bias-corrected 95%CI 0.22, 0.54).INTERPRETATION: Cough characteristics alone are not distinct enough to accurately differentiate between common acute respiratory illnesses in children.
AB - BACKGROUND: Acute respiratory illnesses cause substantial morbidity worldwide. Cough is a common symptom in these childhood respiratory illnesses but there is currently no large cohort data on whether various cough characteristics can differentiate between these aetiologies.RESEARCH QUESTION: Can various clinically-based cough characteristics (frequency [day-time/ night-time], the sound itself, or type [wet/dry]) be used to differentiate common aetiologies (asthma, bronchiolitis, pneumonia, other acute respiratory infections) of acute cough in children?STUDY DESIGN AND METHODS: Between 2017-2019, children aged 2-weeks to ≤16-years hospitalised with asthma, bronchiolitis, pneumonia, other acute respiratory infections, or controls were enrolled. Spontaneous coughs were digitally recorded over 24-hours except for the controls, who provided three voluntary coughs. Coughs were extracted and frequency defined (coughs/hour). Cough sounds and type were assessed independently by two observers blinded to the clinical data. Cough scored by a respiratory specialist was compared to discharge diagnosis using agreement (Cohen's kappa coefficient [қ]), sensitivity, and specificity. Caregiver reported cough scores were related with objective cough frequency using Spearman's coefficient (rs).RESULTS: A cohort of 148 children (n=118 with respiratory illnesses, n=30 controls), median age=2.0 years (interquartile range 0.7, 3.9), 58% males, and 50% First Nations children were enrolled. In those with respiratory illnesses, caregiver reported cough scores and wet cough (range 42-63%) was similar. Overall agreement in diagnosis between the respiratory specialist and discharge diagnosis was slight (қ=0.13, 95%CI 0.03, 0.22). Among diagnoses, specificity (8-74%) and sensitivity (53-100%) varied. Inter-rater agreement in cough type (wet/dry) between blinded observers was almost perfect (қ=0.89, 95%CI 0.81, 0.97). Objective cough frequency was significantly correlated with reported cough scores using visual analogue scale (rs=0.43, bias-corrected 95%CI 0.25, 0.56) and verbal categorical description day-time score (rs=0.39, bias-corrected 95%CI 0.22, 0.54).INTERPRETATION: Cough characteristics alone are not distinct enough to accurately differentiate between common acute respiratory illnesses in children.
KW - acute respiratory infection
KW - asthma
KW - cough
KW - pediatrics
KW - sound recording
UR - http://www.scopus.com/inward/record.url?scp=85098228003&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2020.06.067
DO - 10.1016/j.chest.2020.06.067
M3 - Article
C2 - 32653569
SN - 1931-3543
VL - 159
SP - 259
EP - 269
JO - Chest
JF - Chest
IS - 1
ER -