Subjective scoring of cough in children: parent-completed vs child-completed diary cards vs an objective method

Cough is often used as an outcome measure, although the reporting of cough is unreliable. Using a 24 h ambulatory cough meter to measure cough frequency, the aim of this study was to compare: 1) the correlation of child-completed diary cards to the objective measurement, with that of parent-completed diary cards; and 2) the visual analogue scale (VAS) to the verbal category descriptive (VCD) score. The cough meter consisted of a previously validated Holter monitor and a cough processor. Eighty four children (39 with recurrent cough and 45 controls, aged 6-17 yrs) used a cough meter at least once. Thirty three subjects used the cough meter twice. Parents and children completed separate diary cards using the VAS and VCD scores. The strength of the relationship between the subjective scores and the objective recordings was analysed by spearman's rank correlation coefficient. For daytime cough, child-completed diary cards and the VCD correlated better to the objective measurement than parent-completed diary cards and the VAS, respectively. In subjects that used the cough meter twice, the difference between the cough frequency correlated to the difference in the subjective scores. The confidence intervals for the correlation coefficients were wide. The agreement between the objective and subjective presence of daytime cough was good but that for night-time cough was poor. We conclude that the severity of cough defined on diary cards may not represent cough frequency. Objective readings are first choice but currently not yet practical. The verbal category descriptive diary card completed by children and assisted by parents has the highest correlation to cough frequency measured objectively.

This article has been cited by other articles:

				J. M. Marchant, P. A. Newcombe, E. F. Juniper, J. K. Sheffield, S. L. Stathis, and A. B. Chang What Is the Burden of Chronic Cough for Families? Chest, August 1, 2008; 134(2): 303 - 309. [Abstract] [Full Text] [PDF]

				M D Shields, A Bush, M L Everard, S McKenzie, R Primhak, and on behalf of the British Thoracic Society Cough Gu Recommendations for the assessment and management of cough in children Thorax, April 1, 2008; 63(Suppl_3): iii1 - iii15. [Full Text] [PDF]

				I. B. Masters, P. V. Zimmerman, N. Pandeya, H. L. Petsky, S. B. Wilson, and A. B. Chang Quantified Tracheobronchomalacia Disorders and Their Clinical Profiles in Children* Chest, February 1, 2008; 133(2): 461 - 467. [Abstract] [Full Text] [PDF]

				P. A. Newcombe, J. K. Sheffield, E. F. Juniper, J. M. Marchant, R. A. Halsted, I. B. Masters, and A. B. Chang Development of a Parent-Proxy Quality-of-Life Chronic Cough-Specific Questionnaire*: Clinical Impact vs Psychometric Evaluations Chest, February 1, 2008; 133(2): 386 - 395. [Abstract] [Full Text] [PDF]

				L. J. van der Giessen, R. Gosselink, W. C. J. Hop, and H. A. W. M. Tiddens Recombinant human DNase nebulisation in children with cystic fibrosis: before bedtime or after waking up? Eur. Respir. J., October 1, 2007; 30(4): 763 - 768. [Abstract] [Full Text] [PDF]

				A. B. Chang, P. G. Gibson, J. Ardill, and L. P. A. McGarvey Calcitonin gene-related peptide relates to cough sensitivity in children with chronic cough Eur. Respir. J., July 1, 2007; 30(1): 66 - 72. [Abstract] [Full Text] [PDF]

				A. H. Morice, G. A. Fontana, M. G. Belvisi, S. S. Birring, K. F. Chung, P. V. Dicpinigaitis, J. A. Kastelik, L. P. McGarvey, J. A. Smith, M. Tatar, et al. ERS guidelines on the assessment of cough Eur. Respir. J., June 1, 2007; 29(6): 1256 - 1276. [Full Text] [PDF]

				A. Gupta, M. McKean, and A. B Chang Management of chronic non-specific cough in childhood: an evidence-based review Arch. Dis. Child. Ed. Pract., April 1, 2007; 92(2): 33 - 39. [Full Text] [PDF]

				K. E. Yoder, M. L. Shaffer, S. J. La Tournous, and I. M. Paul Child Assessment of Dextromethorphan, Diphenhydramine, and Placebo for Nocturnal Cough Due to Upper Respiratory Infection Clinical Pediatrics, September 1, 2006; 45(7): 633 - 640. [Abstract] [PDF]

				A H Morice, L McGarvey, I Pavord, and on behalf of the British Thoracic Society Cough Gu Recommendations for the management of cough in adults Thorax, September 1, 2006; 61(suppl_1): i1 - i24. [Full Text] [PDF]

				M D Shields Diagnosing chronic cough in children. Thorax, August 1, 2006; 61(8): 647 - 648. [Full Text] [PDF]

				J M Marchant, I B Masters, S M Taylor, and A B Chang Utility of signs and symptoms of chronic cough in predicting specific cause in children Thorax, August 1, 2006; 61(8): 694 - 698. [Abstract] [Full Text] [PDF]

				J. M. Marchant, I. B. Masters, S. M. Taylor, N. C. Cox, G. J. Seymour, and A. B. Chang Evaluation and Outcome of Young Children With Chronic Cough Chest, May 1, 2006; 129(5): 1132 - 1141. [Abstract] [Full Text] [PDF]

				A. B. Chang and W. B. Glomb Guidelines for Evaluating Chronic Cough in Pediatrics: ACCP Evidence-Based Clinical Practice Guidelines Chest, January 1, 2006; 129(1_suppl): 260S - 283S. [Abstract] [Full Text] [PDF]

				D. Ziora, W. Jarosz, J. Dzielicki, J. Ciekalski, A. Krzywiecki, S. Dworniczak, and J. Kozielski Citric Acid Cough Threshold in Patients With Gastroesophageal Reflux Disease Rises After Laparoscopic Fundoplication Chest, October 1, 2005; 128(4): 2458 - 2464. [Abstract] [Full Text] [PDF]

				I. M. Paul Effect of Dextromethorphan, Diphenhydramine, and Placebo on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents: In Reply Pediatrics, February 1, 2005; 115(2): 512 - 513. [Full Text] [PDF]

				A.H. Morice and committee members The diagnosis and management of chronic cough Eur. Respir. J., September 1, 2004; 24(3): 481 - 492. [Full Text] [PDF]

				I. M. Paul, K. E. Yoder, K. R. Crowell, M. L. Shaffer, H. S. McMillan, L. C. Carlson, D. A. Dilworth, and C. M. Berlin Jr. Effect of Dextromethorphan, Diphenhydramine, and Placebo on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents Pediatrics, July 1, 2004; 114(1): e85 - e90. [Abstract] [Full Text] [PDF]

				J C de Jongste and M D Shields Cough * 2: Chronic cough in children Thorax, November 1, 2003; 58(11): 998 - 1003. [Abstract] [Full Text] [PDF]

				A B Chang, P D Phelan, C F Robertson, R G D Roberts, and S M Sawyer Relation between measurements of cough severity Arch. Dis. Child., January 1, 2003; 88(1): 57 - 60. [Abstract] [Full Text] [PDF]

				A Bush, C O'Callaghan, and A Boon Primary ciliary dyskinesia Arch. Dis. Child., November 1, 2002; 87(5): 363 - 365. [Full Text] [PDF]

				A B Chang, V A Harrhy, J Simpson, I B Masters, and P G Gibson Cough, airway inflammation, and mild asthma exacerbation Arch. Dis. Child., April 1, 2002; 86(4): 270 - 275. [Abstract] [Full Text] [PDF]

				S. Y. Lee, J. Y. Cho, J. J. Shim, H. K. Kim, K. H. Kang, S. H. Yoo, and K. H. In Airway Inflammation as an Assessment of Chronic Nonproductive Cough Chest, October 1, 2001; 120(4): 1114 - 1120. [Abstract] [Full Text] [PDF]

				P. G. GIBSON, J. L. SIMPSON, A. C. CHALMERS, R. C. TONEGUZZI, P. A. B. WARK, A. J. WILSON, and M. J. HENSLEY Airway Eosinophilia Is Associated with Wheeze But Is Uncommon in Children with Persistent Cough and Frequent Chest Colds Am. J. Respir. Crit. Care Med., September 15, 2001; 164(6): 977 - 981. [Abstract] [Full Text] [PDF]