Methods of Cough Assessment

Cho, Peter Siu Pan; Birring, Surinder S.; Fletcher, Hannah; Turner, Richard

doi:10.1016/j.jaip.2019.01.049

Cited by 43 publications

(61 citation statements)

References 141 publications

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“…Moreover, it may be possible to automatically assess cough intensity by calculating the amplitudes of waveforms displayed by our cough monitor. Although it is thought that cough intensity is as important as cough frequency with respect to its impact on quality of life, there is still no portable monitor that has been validated for assessing cough intensity 18 . In future studies, we would like to confirm that our cough monitor is useful not only for measuring cough frequency but also for measuring cough intensity.…”

Section: Discussionmentioning

confidence: 99%

A novel automatic cough frequency monitoring system combining a triaxial accelerometer and a stretchable strain sensor

Otoshi

Nagano

Izumi

et al. 2021

Sci Rep

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Objective evaluations of cough frequency are considered important for assessing the clinical state of patients with respiratory diseases. However, cough monitors with audio recordings are rarely used in clinical settings. Issues regarding privacy and background noise with audio recordings are barriers to the wide use of these monitors; to solve these problems, we developed a novel automatic cough frequency monitoring system combining a triaxial accelerator and a stretchable strain sensor. Eleven healthy adult volunteers and 10 adult patients with cough were enrolled. The participants wore two devices for 30 min for the cough measurements. An accelerator was attached to the epigastric region, and a stretchable strain sensor was worn around their neck. When the subjects coughed, these devices displayed specific waveforms. The data from all the participants were categorized into a training dataset and a test dataset. Using a variational autoencoder, a machine learning algorithm with deep learning, the components of the test dataset were automatically judged as being a “cough unit” or “non-cough unit”. The sensitivity and specificity in detecting coughs were 92% and 96%, respectively. Our cough monitoring system has the potential to be widely used in clinical settings without any concerns regarding privacy or background noise.

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Section: Discussionmentioning

confidence: 99%

A novel automatic cough frequency monitoring system combining a triaxial accelerometer and a stretchable strain sensor

Otoshi

Nagano

Izumi

et al. 2021

Sci Rep

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“…Additionally, different end points and assessments have been used in CC clinical trials, including objective assessment of cough frequency using cough-monitoring devices and subjective cough-related patient-reported outcomes. 104 Well-designed clinical trials including objective cough monitoring will be important to support regulatory approval of novel antitussives for CC.…”

Section: Future Directionsmentioning

confidence: 99%

“…Although the concept of precision medicine for CC is currently aspirational, the heterogeneity and multifactorial nature of cough supports the adaptation of such an approach, including identification of patient subgroups that respond to specific treatments. Additionally, different end points and assessments have been used in CC clinical trials, including objective assessment of cough frequency using cough‐monitoring devices and subjective cough‐related patient‐reported outcomes 104 . Well‐designed clinical trials including objective cough monitoring will be important to support regulatory approval of novel antitussives for CC.…”

Section: Future Directionsmentioning

confidence: 99%

Mechanisms and Rationale for Targeted Therapies in Refractory and Unexplained Chronic Cough

Mazzone

McGarvey

2020

Clin Pharma and Therapeutics

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Chronic cough, defined as a cough lasting > 8 weeks, is a common medical condition that exerts a substantial physical, mental, and social burden on patients. A subset of patients with chronic cough are troubled with a cough that persists despite optimal treatment of presumed associated common and uncommon conditions (refractory chronic cough; RCC) or in which no diagnosable cause for cough can be identified despite extensive assessment (unexplained chronic cough; UCC). Many of these patients exhibit clinical features of cough hypersensitivity, including laryngeal paresthesia, hypertussia, and allotussia. Over-the-counter cough remedies are ineffective and can lead to intolerable side effects when used for RCC/UCC, and the lack of approved treatments indicated for these conditions reflects a major unmet need. An increased understanding of the anatomy and neurophysiology of protective and pathologic cough has fostered a robust clinical development pipeline of several targeted therapies for RCC/UCC. This manuscript reviews the mechanisms presumed to underly RCC/UCC together with the rationale and clinical evidence for several targeted therapies currently under clinical investigation, including transient receptor potential channel antagonists, P2X3-receptor antagonists, voltage-gated sodium channel blockers, neuromodulators, and neurokinin-1-receptor antagonists. Finally, we provide an overview of targets that have been investigated in preclinical models of cough and other airway diseases that may hold future promise for clinical studies in RCC/UCC. Development of targeted therapies with different sites of action may foster a precision medicine approach to treat this heterogeneous, underserved patient population.

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“…Although advances over the last 10-20 years have progressed understanding of the mechanisms and pathophysiology of cough, and of the impact of cough on patients, much remains poorly understood (1). These developments have occurred along with, and have been strongly supported by, tools for measuring cough (2).…”

Section: Introductionmentioning

confidence: 99%

The present and future of cough counting tools

Hall¹,

Lozano²,

Estrada-Petrocelli³

et al. 2020

J Thorac Dis

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The widespread use of cough counting tools has, to date, been limited by a reliance on human input to determine cough frequency. However, over the last two decades advances in digital technology and audio capture have reduced this dependence. As a result, cough frequency is increasingly recognised as a measurable parameter of respiratory disease. Cough frequency is now the gold standard primary endpoint for trials of new treatments for chronic cough, has been investigated as a marker of infectiousness in tuberculosis (TB), and used to demonstrate recovery in exacerbations of chronic obstructive pulmonary disease (COPD).This review discusses the principles of automatic cough detection and summarises key currently and recently used cough counting technology in clinical research. It additionally makes some predictions on future directions in the field based on recent developments. It seems likely that newer approaches to signal processing, the adoption of techniques from automatic speech recognition, and the widespread ownership of mobile devices will help drive forward the development of real-time fully automated ambulatory cough frequency monitoring over the coming years. These changes should allow cough counting systems to transition from their current status as a niche research tool in chronic cough to a much more widely applicable method for assessing, investigating and understanding respiratory disease.

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Methods of Cough Assessment

Cited by 43 publications

References 141 publications

A novel automatic cough frequency monitoring system combining a triaxial accelerometer and a stretchable strain sensor

A novel automatic cough frequency monitoring system combining a triaxial accelerometer and a stretchable strain sensor

Mechanisms and Rationale for Targeted Therapies in Refractory and Unexplained Chronic Cough

The present and future of cough counting tools

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