Can acute cough characteristics from sound recordings differentiate common respiratory illnesses in children?:A comparative prospective study

• Published in: Chest
• Main Authors: Bisballe-Müller, Nina, Chang, Anne B, Plumb, Erin J, Oguoma, Victor M, Halken, Susanne, McCallum, Gabrielle B
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2021
• Subjects: First Nations
• Online Access: https://researchprofiles.canberra.edu.au/en/publications/787a8aa1-67aa-4786-96ae-9b577384b850; https://doi.org/10.1016/j.chest.2020.06.067; https://researchsystem.canberra.edu.au/ws/files/40354877/PIIS0012369220318699.pdf; https://researchsystem.canberra.edu.au/ws/files/43959486/1_s2.0_S0012369220318699_main.pdf; http://www.scopus.com/inward/record.url?scp=85098228003&partnerID=8YFLogxK

BACKGROUND: Acute respiratory illnesses cause substantial morbidity worldwide. Cough is a common symptom in these childhood respiratory illnesses but there is currently no large cohort data on whether various cough characteristics can differentiate between these aetiologies. RESEARCH QUESTION: Can various clinically-based cough characteristics (frequency [day-time/ night-time], the sound itself, or type [wet/dry]) be used to differentiate common aetiologies (asthma, bronchiolitis, pneumonia, other acute respiratory infections) of acute cough in children? STUDY DESIGN AND METHODS: Between 2017-2019, children aged 2-weeks to ≤16-years hospitalised with asthma, bronchiolitis, pneumonia, other acute respiratory infections, or controls were enrolled. Spontaneous coughs were digitally recorded over 24-hours except for the controls, who provided three voluntary coughs. Coughs were extracted and frequency defined (coughs/hour). Cough sounds and type were assessed independently by two observers blinded to the clinical data. Cough scored by a respiratory specialist was compared to discharge diagnosis using agreement (Cohen's kappa coefficient [қ]), sensitivity, and specificity. Caregiver reported cough scores were related with objective cough frequency using Spearman's coefficient (rs). RESULTS: A cohort of 148 children (n=118 with respiratory illnesses, n=30 controls), median age=2.0 years (interquartile range 0.7, 3.9), 58% males, and 50% First Nations children were enrolled. In those with respiratory illnesses, caregiver reported cough scores and wet cough (range 42-63%) was similar. Overall agreement in diagnosis between the respiratory specialist and discharge diagnosis was slight (қ=0.13, 95%CI 0.03, 0.22). Among diagnoses, specificity (8-74%) and sensitivity (53-100%) varied. Inter-rater agreement in cough type (wet/dry) between blinded observers was almost perfect (қ=0.89, 95%CI 0.81, 0.97). Objective cough frequency was significantly correlated with reported cough scores using visual analogue scale (rs=0.43, ...