A Critical Review of the Quality of Cough Clinical Practice Guidelines

Classification of Cough as a Symptom in Adults and Management Algorithms

“…Remark: The updated cough guidelines and algorithms have been based upon systematic reviews that meet the National Academy of Medicine (NAM) standards 31 and cough guidelines that meet the NAM criteria of trustworthy clinical practice guidelines. [32][33][34] chestjournal.org…”

In search for the Holy Grail of cough guidelines

“…While some guidelines published in 2006 scored well and others published more recently did not, the analyses have to be taken in context of the changing post of guideline development while in search of the Holy Grail of cough guidelines. Jiang and colleagues (7) appropriately used the AGREE-II tool for assessing these guidelines but the next version, AGREE Recommendation EXcellence (AGREE-REX), is currently being tested.…”

“…Those accustomed to evidence based medicine are cognisant of the relative paucity of studies to inform these evidence-based guidelines on the management of chronic cough. This was highlighted by some but not all of these guidelines and now confirmed through the analyses undertaken by Jiang and colleagues (7), the first study to compare the different cough guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) tool. While the analyses were done well, it included studies from a decade ago and during this period, major changes in the field of guideline development and evaluation has occurred.…”

“…In an attempt to improve the management of cough, the concept of using a guideline for cough was first initiated by Dr. Irwin in the 1990s (6). Now, there are many guidelines on the management of cough in children and adults (7). Those accustomed to evidence based medicine are cognisant of the relative paucity of studies to inform these evidence-based guidelines on the management of chronic cough.…”

How evidenced based and up to date are our cough guidelines?

“…In the paper "A Critical Review of the Quality of Cough Clinical Practice Guidelines" published in Chest, Jiang et al (2) have provided the first comprehensive assessment of the quality and methodology rigour of the recent cough guidelines. In their analysis, they used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) (3).…”