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Chronic cough—the limitation and advances in assessment techniques

Zhang, Mengru; Sykes, Dominic L.; Brindle, Kayleigh; Sadofsky, Laura R.; Morice, Alyn H.


Mengru Zhang

Dominic L. Sykes

Kayleigh Brindle


Accurate and consistent assessments of cough are essential to advance the understanding of the mechanisms of cough and individualised the management of patients. Considerable progress has been made in this work. Here we reviewed the currently available tools for subjectively and objectively measuring both cough sensitivity and severity. We also provided some opinions on the new techniques and future directions. The simple and practical Visual Analogue Scale (VAS), the Leicester Cough Questionnaire (LCQ), and the Cough Specific Quality of Life Questionnaire (CQLQ) are the most widely used self-reported questionnaires for evaluating and quantifying cough severity. The Hull Airway Reflux Questionnaire (HARQ) is a tool to elucidate the constellation of symptoms underlying the diagnosis of chronic cough. Chemical excitation tests are widely used to explore the pathophysiological mechanisms of the cough reflex, such as capsaicin, citric acid and adenosine triphosphate (ATP) challenge test. Cough frequency is an ideal primary endpoint for clinical research, but the application of cough counters has been limited in clinical practice by the high cost and reliance on aural validation. The ongoing development of cough detection technology for smartphone apps and wearable devices will hopefully simplify cough counting, thus transitioning it from niche research to a widely available clinical application.


Zhang, M., Sykes, D. L., Brindle, K., Sadofsky, L. R., & Morice, A. H. (2022). Chronic cough—the limitation and advances in assessment techniques. Journal of thoracic disease, 14(12), 5097-5119.

Journal Article Type Review
Acceptance Date Nov 4, 2022
Online Publication Date Dec 30, 2022
Publication Date 2022-12
Deposit Date Jan 30, 2023
Publicly Available Date Jan 30, 2023
Journal Journal of Thoracic Disease
Print ISSN 2072-1439
Electronic ISSN 2077-6624
Peer Reviewed Peer Reviewed
Volume 14
Issue 12
Pages 5097-5119
Keywords Chronic cough; Cough reflex sensitivity; Quality of life (QoL); Questionnaires; Cough frequency
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© Journal of Thoracic Disease. All rights reserved.
Open Access Statement: This is an Open Access article
distributed in accordance with the Creative Commons
Attribution-NonCommercial-NoDerivs 4.0 International
License (CC BY-NC-ND 4.0), which permits the noncommercial
replication and distribution of the article with
the strict proviso that no changes or edits are made and the
original work is properly cited (including links to both the
formal publication through the relevant DOI and the license).

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