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

Classification of Cough as a Symptom in Adults and Management Algorithms

Pdf Summary

The CHEST Guideline and Expert Panel Report evaluates the effectiveness and global applicability of the CHEST 2006 guidelines for classifying and managing cough in adults based on its duration: acute (≤3 weeks), subacute (3-8 weeks), and chronic (≥8 weeks). The report employs a systematic review methodology adhering to the CHEST and American College of Chest Physicians guidelines, using the PICO (Population, Intervention, Comparator, Outcome) framework. <br /><br />For acute cough, primarily caused by viral infections or exacerbations of conditions like asthma and COPD, only three studies met quality assessment criteria but with a high risk of bias. In contrast, chronic cough studies were more numerous, with 11 meeting the criteria, indicating varied causes including upper airway cough syndrome (UACS), asthma, gastroesophageal reflux disease (GERD), and nonasthmatic eosinophilic bronchitis. Subacute cough, less studied, typically stems from postinfectious cough and similar conditions as chronic cough.<br /><br />Recommendations from the review suggest that cough management should begin by determining its duration to narrow diagnostic possibilities. Despite the evidence quality being low, the CHEST guidelines are found useful globally but need updates reflecting medical advancements. They now include broader assessments such as considering tuberculosis in endemic areas or high-risk groups, using validated tools for evaluating cough severity, and recommending follow-ups to ensure effective management. <br /><br />The report emphasizes further research using validated tools to enhance understanding of cough causes and consequences, as well as developing electronic management tools for wider implementation of these updated guidelines. Overall, the guidelines remain a trusted framework for healthcare providers globally, aligning with updated standards of trustworthy clinical practice guidelines.

Keywords

CHEST guidelines

cough management

acute cough

chronic cough

subacute cough

systematic review

PICO framework

cough duration

global applicability

evidence quality