CHEST Guidelines-Classification-of-Cough-as-a-Symptom-in-Adults-and

Classification-of-Cough-as-a-Symptom-in-Adults-and

Pdf Summary

The CHEST Guideline and Expert Panel Report explores the classification of cough in adults and the corresponding management algorithms, initially established in 2006, based on the duration of cough: acute (≤3 weeks), subacute (3-8 weeks), and chronic (≥8 weeks). The report, developed by the CHEST Expert Cough Panel led by Richard S. Irwin, MD, and others, discusses systematic reviews conducted using the PICO framework (Population, Intervention, Comparison, Outcome) to assess the usefulness of these categorizations in diagnosis and treatment.<br /><br />The study includes studies from North America, Europe, Asia, and incorporates varying causes of cough as outlined in the 2006 guidelines. The continuation and global relevance of these guidelines are affirmed, despite the low quality of evidence and high risk of bias noted in the studies reviewed. It reveals that acute cough is often caused by respiratory infections and conditions like asthma, COPD, and viral infections. Subacute cough is predominantly due to postinfectious causes or underlying conditions, while chronic cough is largely attributed to upper airway cough syndrome (UACS), asthma, gastroesophageal reflux disease (GERD), and nonasthmatic eosinophilic bronchitis.<br /><br />The 2018 report updates these algorithms, incorporating considerations for contemporary issues like tuberculosis, red flags in diagnosis, and validated tools for assessing cough severity and quality of life. The recommendations emphasize the importance of assessing the cough's duration as a critical step in clinical diagnosis and suggest retaining these evidence-based categorizations across global practices. Future research directions highlighted include enhancing study quality through validated tools and potentially creating digital guideline tools to improve adherence and outcomes.

Keywords

cough classification

management algorithms

CHEST Expert Cough Panel

PICO framework

acute cough

subacute cough

chronic cough

upper airway cough syndrome

gastroesophageal reflux disease

cough severity assessment