The development of the Cough Hypersensitivity Questionnaire (CHQ) for chronic cough

B. Hirons, P. Cho, Chris Krägeloh, Richard J. Siegert, Richard Turner, K. Rhatigan, Harini Kesavan, E. Mackay, Ha-Kyeong Won, Ju-Young Kim, Woo-Jung Song, S. Birring
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Abstract

Chronic cough is considered a disorder of neuronal hypersensitivity in which patients frequently report abnormal laryngeal and chest sensations, and excessive triggers. To facilitate clinical assessment we developed the Cough Hypersensitivity Questionnaire (CHQ).Candidate questionnaire items were developed following interviews with patients with refractory chronic cough (n=10, United Kingdom), and review by a multidisciplinary team. The CHQ was evaluated in individuals with chronic cough (n=535, UK/South Korea), for uni-dimensionality and differential item functioning (with Rasch Analysis), internal consistency, concurrent validity (against cough severity visual analogue scale (VAS) and Leicester Cough Questionnaire (LCQ) scores), and content validity (cognitive debriefing interviews, n=13).Concept elicitation created a pool of 34 items. Eleven were removed following multidisciplinary team review of patient interviews. Rasch analysis confirmed the CHQ total score to be a unidimensional scale; one item was removed due to differential item functioning. The final 22 binary-item CHQ comprises 6 sensation-related and 16 trigger-related items.Median (IQR) total CHQ scores were 9 (6–12); sensations 4 (2–5), triggers 5 (3–8). Internal consistency was good (person separation index 0.74). The CHQ total score was moderately associated with cough severity VAS (0.42, p=0.005) and LCQ total score (ρ=−0.52, p<0.001). In cognitive debriefing, patients found the CHQ relevant to their condition and simple to complete.The CHQ is simple to use and has validity for assessing cough triggers and sensations in patients with chronic cough. Further studies are needed to assess its repeatability, responsiveness, and clinical utility.
开发用于慢性咳嗽的咳嗽过敏性问卷(CHQ)
慢性咳嗽被认为是一种神经元超敏性疾病,患者经常报告喉部和胸部感觉异常以及诱因过多。为了便于临床评估,我们开发了咳嗽超敏性问卷(CHQ)。在对难治性慢性咳嗽患者(10 人,英国)进行访谈并由多学科团队进行审查后,我们开发了候选问卷项目。在慢性咳嗽患者(人数=535,英国/韩国)中对 CHQ 进行了评估,以确定其单维性和差异项目功能(采用 Rasch 分析法)、内部一致性、并发效度(与咳嗽严重程度视觉模拟量表(VAS)和莱斯特咳嗽问卷(LCQ)得分相对照)和内容效度(认知汇报访谈,人数=13)。在多学科团队对患者访谈进行审查后,删除了 11 个项目。Rasch 分析证实 CHQ 总分是一个单维量表;由于项目功能不同,删除了一个项目。CHQ 总分的中位数(IQR)为 9 (6-12);感觉 4 (2-5),触发 5 (3-8)。内部一致性良好(人称分离指数为 0.74)。CHQ 总分与咳嗽严重程度 VAS(0.42,p=0.005)和 LCQ 总分(ρ=-0.52,p<0.001)呈中度相关。在认知汇报中,患者认为 CHQ 与他们的病情相关,而且填写简单。还需要进一步的研究来评估其可重复性、响应性和临床实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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