Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical setting

Allan Klitgaard*, Anders Løkke, Jannie Frølund, Steffen Kristensen, Ole Hilberg

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Cough is a condition that can be caused by several different mechanisms. There are numerous guidelines for diagnosing the cause of cough, yet the effect of a well-constructed examination framework has not been investigated. At the Department of Internal Medicine, Lillebaelt Hospital, Vejle, a systematic examination framework for diagnosing cough was introduced. Two hundred consecutive patients referred to the pulmonary outpatient clinic with cough were included. The first 100 patients (Group 1) were included before implementation of the examination framework and diagnosed as usual. The next 100 patients (Group 2) were examined using the systematic framework. The primary endpoint was the number of appointments required to establish a diagnosis. A multivariable Poisson regression was performed, adjusting for age, sex, body mass index, pulmonary function (FEV1/FVC), duration of cough, and smoking status. A diagnosis was established within 1–2 visits in 47% in Group 1 compared to 83% in Group 2. When adjusting for confounders, fewer appointments was required to establish a diagnosis in Group 2 (Incidence rate ratio = 0.713 (95% confidence interval: 0.592–0.859), P = 0.000). Using a systematic examination framework for diagnosing cough may reduce the number of appointments required to establish a diagnosis, seemingly without compromising the diagnostic outcome.

Original languageEnglish
Article number2273026
JournalEuropean Clinical Respiratory Journal
Volume10
Issue number1
Number of pages10
ISSN2001-8525
DOIs
Publication statusPublished - 31. Dec 2023

Keywords

  • Cough
  • diagnosis
  • patient pathways
  • systematic framework
  • time to diagnosis

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