COSMIN database

Evaluating cough assessment tools: a systematic review

Schmit, K. M., Coeytaux, R. R., Goode, A. P., McCrory, D. C., Yancy, W. S., Jr., Kemper, A. R., Hasselblad, V., Heidenfelder, B. L., and Sanders, G. D.
BACKGROUND: Little is known about the comparative validity, reliability, or responsiveness of instruments for assessing cough frequency or impact, where the term impact encompasses both cough severity and the impact of cough on health-related quality of life.

METHODS: We conducted a systematic review to evaluate instruments that assess cough frequency or impact in adults, adolescents, and children with acute or chronic cough.

RESULTS: Seventy-eight studies were included, of which eight were randomized controlled trials and 70 were observational studies. In all age groups, audio and video electronic recording devices had good reliability compared with other methods of assessing cough frequency but had variable correlation with other cough assessments, such as visual analog scale scores, quality-of-life questionnaires, cough diaries, and tussigenic challenges. Among adult and adolescent patients, the Leicester Cough Questionnaire (LCQ) and the Cough-Specific Quality-of-Life Questionnaire (CQLQ) were valid and reliable, showing high intraclass and test-retest correlations. Among children, the Parent Cough-Specific Quality of Life Questionnaire and Pediatric Cough Questionnaire were valid and reliable.

CONCLUSIONS: Electronic recording devices can be valid assessments of cough frequency. The LCQ and CQLQ for adults and the Parent Cough-Specific Quality of Life questionnaire for children are valid instruments for assessing cough impact. There is limited but insufficient evidence to determine the reliability or concurrent validity of the different types of cough diaries or visual analog scale scores. There are also limited data to support the responsiveness of recording devices. There is good responsiveness data for the LCQ and CQLQ, but more evidence is needed.
1931-3543 (Electronic)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Symptom status:
Physical state
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the respiratory system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
3 - Diaries
5 - Videos
6 - Clinical rating scales
7 - Observations
9 - Laboratory tests
24-h (ambulatory) recorder - 24-hour (ambulatory) recorder
24-h cough recording - 24-hour cough recording
ACOS - Adverse Cough Outcome Survey
Audio cough recorder
CASA-Q - Cough and Sputum Assessment Questionnaire
CBSAS - Chronic Bronchitis Symptoms Assessment Scale
CCIQ - Chronic Cough Impact Questionnaire
Child Cough Score
Cough frequency score
Cough recorder
CQLQ - Cough Quality of Life Questionnaire [alias: Cough-specific Quality of Life Questionnaire]
CSD - Cough Severity Diary
DATA recording system - Discriminator and Accumulator of Tussive Activity recording system
Electronic cough recorder
FCSF - Fisman Cough Severity/Frequency
GRC - Global Rating of Change
HACC - Hull Automated Cough Counter
Human cough count
LCCQ - Lung Cancer Cough Questionnaire
LCM - Leicester Cough Monitor
LifeShirt (combination of plethysmography, ECG, and EMG)
LR100 (EMG + audio signal) also Modified LR100
LR102 recording device
Parental cough score
Parental questionnaire
PC-QOL - Parent Cough-Specific Quality-of-Life questionnaire
PCQ - Pediatric Cough Questionnaire
Portable automatic cough analyzer
Punum Ladder
QLTP - Questionnaire for Lung Transplant Patients
Tussigenic challenge
VAS - Visual Analogue Scale   
VCD - verbal category descriptive scale
video observations [alias: video recorder]