ERS guidelines on the assessment of cough

Cough

1) All basic scientific articles should refer to cough as a three-phase motor act. For the purposes of acoustic recordings in clinical studies, however, cough should be described as a forced expulsive manoeuvre or manoeuvres against a closed glottis that are associated with a characteristic sound or sounds.

2) All scientific articles should include a clear definition of what the authors have used as their definition of cough.

Capsaicin and citric acid inhalation cough challenge

1) The methodology for the performance of inhalation cough challenge should be standardised so as to facilitate universal interpretation and comparison of data generated by different laboratories.

2) Comprehensive normal ranges need to be developed using the standardised methodology advocated in the present document.

3) The single-breath concentration–response method using a flow-limited dosimeter is recommended for most experimental protocols.

4) Both C₂ and C₅ should be recorded.

5) Since there is wide inter-individual variation, cough challenge data have no intrinsic significance, but may usefully be used to follow change in cough reflex sensitivity in an individual.

Cough induced by inhalation of aqueous solutions

1) Aerosolised aqueous solutions represent a useful experimental tool in cough research.

2) The cough challenge with ultrasonic distilled water (fog) is difficult to standardise since it is highly dependent upon nebuliser output.

3) Consideration should be given to potential adverse events, such as bronchoconstriction and cross-infection.

Cough monitors

1) No cough monitor is currently the gold standard.

2) Monitors should be developed that are ambulatory, are capable of being digitally processed and permit prolonged (24-h) recording.

3) There is little to commend any particular method of quantifying cough over any other.

Assessment of quality of life of patients with chronic cough

1) Cough can have profound effects on health status, which can be assessed by cough-specific health status questionnaires.

2) Cough visual analogue scale (VAS, 0–100 mm) should be used to assess cough severity in patients with chronic cough.

3) Patients with chronic cough should be assessed with cough-specific quality-of-life questionnaires in clinical studies.

Animal models of cough

1) The most useful animal model of cough is …