Simultaneous versus video counting of coughs in hypertonic cough challenges
2008

Comparing Cough Counting Methods in Hypertonic Challenges

Sample size: 66 publication 10 minutes Evidence: moderate

Author Information

Author(s): Koskela Heikki O, Purokivi Minna K, Tukiainen Raija M

Primary Institution: Department of Respiratory Medicine, Kuopio University Hospital

Hypothesis

Is video recording of cough counting superior to simultaneous counting during hypertonic cough challenges?

Conclusion

Video counting is advisable for hypertonic histamine challenges but unnecessary for hypertonic saline challenges.

Supporting Evidence

  • Video counting showed significantly higher cough counts during hypertonic histamine challenges.
  • Simultaneous counting may miss coughs at high frequencies due to divided attention.
  • The study included 1984 observation minutes for saline and 5373 for histamine challenges.
  • Trained nurses counted coughs during challenges and from video recordings.
  • Video recording allows for repeated viewing to ensure accurate cough counting.
  • Simultaneous counting detected fewer coughs than video counting during high-frequency coughing.
  • Video counting is considered the 'gold standard' for cough counting.
  • Environmental factors can affect the accuracy of simultaneous cough counting.

Takeaway

This study looked at two ways to count coughs during tests. It found that using video is better when people cough a lot, but not needed when they cough less.

Methodology

The study analyzed cough counts from 82 saline challenges and 136 histamine challenges using both simultaneous and video counting methods.

Potential Biases

Potential bias due to the same nurse counting both methods without blinding.

Limitations

The individual counting coughs from video was not blinded to the simultaneous counts, which may introduce bias.

Participant Demographics

66 subjects, including healthy individuals and patients with chronic cough, with a mean age of 50 years.

Statistical Information

P-Value

0.23 for saline challenge, p < 0.001 for histamine challenge

Confidence Interval

95% limits of agreement for saline: -1.2 to 1.2 coughs/min; for histamine: -1.9 to 2.5 coughs/min

Statistical Significance

p < 0.001

Digital Object Identifier (DOI)

10.1186/1745-9974-4-8

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