Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical setting
ABSTRACTCough is a condition that can be caused by several different mechanisms. There are numerous guidelines for diagnosing the cause of cough, yet the effect of a well-constructed examination framework has not been investigated. At the Department of Internal Medicine, Lillebaelt Hospital, Vejle,...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2023-01-01
|
| Series: | European Clinical Respiratory Journal |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/20018525.2023.2273026 |
| _version_ | 1797448958617845760 |
|---|---|
| author | Allan Klitgaard Anders Løkke Jannie Frølund Steffen Kristensen Ole Hilberg |
| author_facet | Allan Klitgaard Anders Løkke Jannie Frølund Steffen Kristensen Ole Hilberg |
| author_sort | Allan Klitgaard |
| collection | DOAJ |
| description | ABSTRACTCough is a condition that can be caused by several different mechanisms. There are numerous guidelines for diagnosing the cause of cough, yet the effect of a well-constructed examination framework has not been investigated. At the Department of Internal Medicine, Lillebaelt Hospital, Vejle, a systematic examination framework for diagnosing cough was introduced. Two hundred consecutive patients referred to the pulmonary outpatient clinic with cough were included. The first 100 patients (Group 1) were included before implementation of the examination framework and diagnosed as usual. The next 100 patients (Group 2) were examined using the systematic framework. The primary endpoint was the number of appointments required to establish a diagnosis. A multivariable Poisson regression was performed, adjusting for age, sex, body mass index, pulmonary function (FEV1/FVC), duration of cough, and smoking status. A diagnosis was established within 1–2 visits in 47% in Group 1 compared to 83% in Group 2. When adjusting for confounders, fewer appointments was required to establish a diagnosis in Group 2 (Incidence rate ratio = 0.713 (95% confidence interval: 0.592–0.859), P = 0.000). Using a systematic examination framework for diagnosing cough may reduce the number of appointments required to establish a diagnosis, seemingly without compromising the diagnostic outcome. |
| first_indexed | 2024-03-09T14:18:09Z |
| format | Article |
| id | doaj.art-deef34a3fe9e4ca1bee84c4f4a31c57b |
| institution | Directory Open Access Journal |
| issn | 2001-8525 |
| language | English |
| last_indexed | 2024-03-09T14:18:09Z |
| publishDate | 2023-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Clinical Respiratory Journal |
| spelling | doaj.art-deef34a3fe9e4ca1bee84c4f4a31c57b2023-11-28T19:19:58ZengTaylor & Francis GroupEuropean Clinical Respiratory Journal2001-85252023-01-0110110.1080/20018525.2023.2273026Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical settingAllan Klitgaard0Anders Løkke1Jannie Frølund2Steffen Kristensen3Ole Hilberg4Department of Internal Medicine, Lillebaelt Hospital, Vejle, DenmarkDepartment of Internal Medicine, Lillebaelt Hospital, Vejle, DenmarkDepartment of Internal Medicine, Lillebaelt Hospital, Vejle, DenmarkDepartment of Internal Medicine, Goedstrup Hospital, Herning, DenmarkDepartment of Internal Medicine, Lillebaelt Hospital, Vejle, DenmarkABSTRACTCough is a condition that can be caused by several different mechanisms. There are numerous guidelines for diagnosing the cause of cough, yet the effect of a well-constructed examination framework has not been investigated. At the Department of Internal Medicine, Lillebaelt Hospital, Vejle, a systematic examination framework for diagnosing cough was introduced. Two hundred consecutive patients referred to the pulmonary outpatient clinic with cough were included. The first 100 patients (Group 1) were included before implementation of the examination framework and diagnosed as usual. The next 100 patients (Group 2) were examined using the systematic framework. The primary endpoint was the number of appointments required to establish a diagnosis. A multivariable Poisson regression was performed, adjusting for age, sex, body mass index, pulmonary function (FEV1/FVC), duration of cough, and smoking status. A diagnosis was established within 1–2 visits in 47% in Group 1 compared to 83% in Group 2. When adjusting for confounders, fewer appointments was required to establish a diagnosis in Group 2 (Incidence rate ratio = 0.713 (95% confidence interval: 0.592–0.859), P = 0.000). Using a systematic examination framework for diagnosing cough may reduce the number of appointments required to establish a diagnosis, seemingly without compromising the diagnostic outcome.https://www.tandfonline.com/doi/10.1080/20018525.2023.2273026Coughdiagnosispatient pathwayssystematic frameworktime to diagnosis |
| spellingShingle | Allan Klitgaard Anders Løkke Jannie Frølund Steffen Kristensen Ole Hilberg Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical setting European Clinical Respiratory Journal Cough diagnosis patient pathways systematic framework time to diagnosis |
| title | Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical setting |
| title_full | Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical setting |
| title_fullStr | Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical setting |
| title_full_unstemmed | Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical setting |
| title_short | Introduction of a systematic examination framework for chronic cough: a before-after cohort study in a clinical setting |
| title_sort | introduction of a systematic examination framework for chronic cough a before after cohort study in a clinical setting |
| topic | Cough diagnosis patient pathways systematic framework time to diagnosis |
| url | https://www.tandfonline.com/doi/10.1080/20018525.2023.2273026 |
| work_keys_str_mv | AT allanklitgaard introductionofasystematicexaminationframeworkforchroniccoughabeforeaftercohortstudyinaclinicalsetting AT andersløkke introductionofasystematicexaminationframeworkforchroniccoughabeforeaftercohortstudyinaclinicalsetting AT janniefrølund introductionofasystematicexaminationframeworkforchroniccoughabeforeaftercohortstudyinaclinicalsetting AT steffenkristensen introductionofasystematicexaminationframeworkforchroniccoughabeforeaftercohortstudyinaclinicalsetting AT olehilberg introductionofasystematicexaminationframeworkforchroniccoughabeforeaftercohortstudyinaclinicalsetting |