Chest
Evidence-Based MedicineAssessment of Intervention Fidelity and Recommendations for Researchers Conducting Studies on the Diagnosis and Treatment of Chronic Cough in the Adult
Section snippets
Summary of Recommendations and Suggestions
- 1.
In conducting studies of chronic cough in adults, we recommend that investigators, as a first step, include intervention fidelity in the design of their studies of the diagnosis and treatment of chronic cough, by addressing intervention fidelity in the following 5 areas: study design, training of providers, treatment delivery, treatment receipt, and enactment of treatment (Grade 1C).
- 2.
In conducting studies of chronic cough in adults, we recommend, as a second step, that the training of
Systematic Review
The Executive Committee of the CHEST Expert Cough Panel convened a writing committee to develop recommendations or suggestions that pertain to the assessment of intervention fidelity in studies of the use of guidelines or protocols to diagnose and manage chronic cough in adults. This writing committee based its recommendations or suggestions on a systematic review contained within this article. This systematic review follows the “Methodologies for the Development of the Management of Cough:
Results
Systematic review results are addressed first and categorized according to the study aims. This is followed by the results of the process for establishing guideline recommendations or consensus-based suggestions.
Recommendations and Suggestions
Based upon the systematic review, the Expert Cough Panel was able to make a series of recommendations and/or suggestions for the use of intervention fidelity, by those conducting research, in studies of adults with chronic cough who are being diagnosed and managed using an evidence-based clinical practice guideline or protocol. The recommendations or suggestions are presented in stepwise fashion to provide a systematic plan in logical sequential order so that all five areas of intervention
Areas for Future Research and Clinical Practice
To advance the field and provide trustworthy guidelines to guide clinical practice, there are a number of potential future research issues that should be addressed. They are enumerated below:
- •
To improve the internal and external validity of future studies seeking to diagnose and manage chronic cough in adults, researchers should use the recommendations and suggestions related to intervention fidelity made in this document. If researchers are not able to use these recommendations, they
Conclusions
Since publication of the 2006 Chest Cough Guidelines, and based upon this systematic review, it is clear that some of the variability in the reporting of successful management patients with chronic cough may be due to lack of intervention fidelity. Using these results, the Expert Cough Panel has been able to make a series of recommendations and suggestions directed at researchers for carrying out future studies of chronic cough in adults. By following the recommendations and suggestions in this
Acknowledgments
Author contributions: C. T. F. and R. S. I. contributed as topic editors for this article; R. L. D. contributed as the appointed methodologist and guided the systematic review that formed the basis for the recommendations; C. T. F., R. L. D., and R. S. I. contributed to the development of the key questions using the PICOTS format, review of the data, and elaboration of recommendations, including their grading; C. T. F. and R. S. I. drafted, wrote, reviewed, and approved the manuscript; and R.
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Authors' response
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2022, Annals of Allergy, Asthma and ImmunologyThe Evolving Clinical Practice of Chronic Cough
2022, Mayo Clinic ProceedingsCitation Excerpt :This is defined by the American College of Chest Physicians (ACCP) as persistence of cough despite a thorough algorithmic approach towards testing and treating for GERD, UACS, and airway inflammatory disorders as well as ensuring avoidance of smoking, environmental triggers, and angiotensin-converting enzyme inhibitor use (Figure 1).14,15 Whereas multiple etiologies for chronic cough can coexist in the same patient,16 many patients may not have undergone rigorous diagnostic tests and standardized therapeutic trials for their chronic cough.14 Thus, it is imperative to undertake a thorough and complete inventory of the patient’s diagnostic as well therapeutic journey before applying the label of RCC or UCC.
Managing unexplained chronic cough in adults: what are the unmet needs?
2020, The Lancet Respiratory Medicine
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