Diagnostics of Spontaneous Cough in Childhood Asthma

Rietveld, Simon; Rijssenbeek‐Nouwens, Lucia H.

doi:10.1378/chest.113.1.50

Cited by 29 publications

(9 citation statements)

References 27 publications

(10 reference statements)

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“…The results showed that children with asthma coughed significantly more often than control subjects during exacerbations, but not during remission. 26 This is in contrast to our study in which we found that children with stable asthma had an increased cough frequency compared with data previously obtained from normal school children. 9 Furthermore, we have found that cough frequency is greater during the day than at night, despite conventional teaching on the importance of night cough in asthma.…”

Section: Discussioncontrasting

confidence: 99%

Cough frequency in children with stable asthma: correlation with lung function, exhaled nitric oxide, and sputum eosinophil count

2003

Thorax

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Background: A study was undertaken to assess the correlation between cough frequency in asthmatic children with lung function and two non-invasive markers of airway inflammation. Methods: Thirty two children of median age 12.0 years (interquartile range (IQR) 9.5-13.4) with stable asthma were recruited. They underwent spirometric testing, exhaled nitric oxide (eNO) measurement, sputum induction for differential cell count, and ambulatory cough monitoring over 17 hours and 40 minutes. Coughing episodes were counted both as individual spikes and as clusters. Results: Complete cough frequency data were available in 29 children (90%) and their median forced expiratory volume in 1 second (FEV 1 ) and eNO were 88.5% (IQR 79.5-98) and 23.9 ppb (IQR 11.4-41.5), respectively. The median number of cough episodes was 14 (IQR 7.0-24.0) which was significantly higher than that of normal children (6.7 (IQR 4.1-10.5), p,0.001). Sputum induction was successful in 61% of the subjects; the median induced sputum eosinophil count was 0.05% (IQR 0-9.0). Cough frequency was found to have a significant positive correlation with eNO (Spearman's r = 0.781, p,0.001) but not with FEV 1 or sputum eosinophil count (r = 20.270, p = 0.157; r = 0.173, p = 0.508, respectively). Conclusions: Children with stable asthma have increased cough frequency compared with normal controls and cough frequency was greater during the day than at night. Cough may be a more sensitive marker of airway inflammation than simple spirometry.

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Section: Discussioncontrasting

confidence: 99%

Cough frequency in children with stable asthma: correlation with lung function, exhaled nitric oxide, and sputum eosinophil count

2003

Thorax

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“…Consistent with other studies (Davis, DiSantostefano, & Peden, 2011; Rietveld & Rijssenbeek-Nouwens, 1998; Wildhaber, Carroll, & Brand, 2012), coughing was the most common symptom experienced by those with uncontrolled asthma, followed by wheezing and shortness of breath. Participants also reported other miscellaneous symptoms that have rarely been mentioned in the literature, suggesting a wide range of asthma symptoms that adolescents perceive as a manifestation of uncontrolled asthma.…”

Section: Discussionsupporting

confidence: 90%

Symptoms, Feelings, Activities and Medication Use in Adolescents With Uncontrolled Asthma: Lessons Learned From Asthma Diaries

Rhee

Fairbanks

Butz

2014

Journal of Pediatric Nursing

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This study was to describe symptoms, feelings, activities and medication use reported by adolescents with uncontrolled asthma on their 24-hour asthma diaries. Adolescents with uncontrolled asthma (13-17 years, N=29) completed asthma diaries and audio-recorded symptom sounds for 24 hours. A variety of symptoms were reported, and the most frequently reported symptoms were coughing followed by wheezing. Most self-reported coughing and wheezing were verified by audio-recordings. Participants reported predominantly negative feelings and low levels of activities. High discordance between self-reports and medical records in medications was noted, raising a concern of poor treatment adherence in this vulnerable group.

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“…Due to the challenges involved in distinguishing wheezes from environmental noises using regular microphones, we decided to concentrate our efforts on coughs alone for the further refinement of the device. A cough is the most common symptom experienced by pediatric patients with uncontrolled asthma [34-37]. Therefore, we believe detecting coughs alone could add value to this device as a monitoring tool.…”

Section: Discussionmentioning

confidence: 99%

The Development of an Automated Device for Asthma Monitoring for Adolescents: Methodologic Approach and User Acceptability

Rhee¹,

Miner²,

Sterling³

et al. 2014

JMIR mHealth uHealth

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BackgroundMany adolescents suffer serious asthma related morbidity that can be prevented by adequate self-management of the disease. The accurate symptom monitoring by patients is the most fundamental antecedent to effective asthma management. Nonetheless, the adequacy and effectiveness of current methods of symptom self-monitoring have been challenged due to the individuals’ fallible symptom perception, poor adherence, and inadequate technique. Recognition of these limitations led to the development of an innovative device that can facilitate continuous and accurate monitoring of asthma symptoms with minimal disruption of daily routines, thus increasing acceptability to adolescents.ObjectiveThe objectives of this study were to: (1) describe the development of a novel symptom monitoring device for teenagers (teens), and (2) assess their perspectives on the usability and acceptability of the device.MethodsAdolescents (13-17 years old) with and without asthma participated in the evolution of an automated device for asthma monitoring (ADAM), which comprised three phases, including development (Phase 1, n=37), validation/user acceptability (Phase 2, n=84), and post hoc validation (Phase 3, n=10). In Phase 1, symptom algorithms were identified based on the acoustic analysis of raw symptom sounds and programmed into a popular mobile system, the iPod. Phase 2 involved a 7 day trial of ADAM in vivo, and the evaluation of user acceptance using an acceptance survey and individual interviews. ADAM was further modified and enhanced in Phase 3.ResultsThrough ADAM, incoming audio data were digitized and processed in two steps involving the extraction of a sequence of descriptive feature vectors, and the processing of these sequences by a hidden Markov model-based Viterbi decoder to differentiate symptom sounds from background noise. The number and times of detected symptoms were stored and displayed in the device. The sensitivity (true positive) of the updated cough algorithm was 70% (21/30), and, on average, 2 coughs per hour were identified as false positive. ADAM also kept track of the their activity level throughout the day using the mobile system’s built in accelerometer function. Overall, the device was well received by participants who perceived it as attractive, convenient, and helpful. The participants recognized the potential benefits of the device in asthma care, and were eager to use it for their asthma management.ConclusionsADAM can potentially automate daily symptom monitoring with minimal intrusiveness and maximal objectivity. The users’ acceptance of the device based on its recognized convenience, user-friendliness, and usefulness in increasing symptom awareness underscores ADAM’s potential to overcome the issues of symptom monitoring including poor adherence, inadequate technique, and poor symptom perception in adolescents. Further refinement of the algorithm is warranted to improve the accuracy of the device. Future study is also needed to assess the efficacy of the device in promoting self-management and ast...

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Diagnostics of Spontaneous Cough in Childhood Asthma

Cited by 29 publications

References 27 publications

Cough frequency in children with stable asthma: correlation with lung function, exhaled nitric oxide, and sputum eosinophil count

Cough frequency in children with stable asthma: correlation with lung function, exhaled nitric oxide, and sputum eosinophil count

Symptoms, Feelings, Activities and Medication Use in Adolescents With Uncontrolled Asthma: Lessons Learned From Asthma Diaries

The Development of an Automated Device for Asthma Monitoring for Adolescents: Methodologic Approach and User Acceptability

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