The online Cough Clinic: developing guideline-based diagnosis and advice
Open accessAbstract
The aim of the present study was make chronic cough guidelines more practical and user friendly by developing an internet-based interactive diagnostic questionnaire for chronic cough. A prospective cohort study of chronic cough sufferers was conducted in the UK, following European Respiratory Society guidelines for the diagnosis and management of chronic cough. Depending on the response to 16 specific questions, the medical condition responsible for the patient's chronic cough was ascertained according to a predetermined diagnostic algorithm designed to differentiate the three common causes of chronic cough. Appropriate advice and treatment recommendations were then provided. 8,546 adults with chronic cough completed the Cough Clinic diagnostic questionnaire. 46.1% were suggested to have reflux, 38.7% asthma and 15.2% rhinitis. Participants found the website easy to use (94%), the advice helpful (73%) and that it helped them to communicate with their general practitioner better (60%), and 62% reported taking the recommended treatment. The Cough Clinic, an internet-based diagnostic site for chronic cough, had a large uptake by chronic cough sufferers in the UK. Almost half were diagnosed as having reflux as the probable cause of their chronic cough. Internet diagnosis by expert algorithm provides a novel mechanism for patients to access guideline-recommended therapies and enhances dialogue between patients and physicians.
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Cites
Clinical guidelines: Potential benefits, limitations, and harms of clinical guidelines
Woolf, S. H., Grol, R. P. T. M., Hutchinson, A., Eccles, M., & Grimshaw, J. (1999) · BMJ · doi:10.1136/bmj.318.7182.527 · Cited by 2,549 · see citing works
Development and validation of a questionnaire to measure asthma control
Juniper, E. F., O′byrne, P. M., Guyatt, G. H., Ferrie, P. J., & King, D. R. (1999) · European Respiratory Journal · doi:10.1034/j.1399-3003.1999.14d29.x · Cited by 2,473 · see citing works
Validity and Reliability of the Reflux Symptom Index (RSI)
Belafsky, P. C., Postma, G. N., & Koufman, J. A. (2002) · Journal of Voice · doi:10.1016/s0892-1997(02)00097-8 · Cited by 1,526 · see citing works
Clinical practice guidelines : directions for a new program
Field, M. J., & Lohr, K. N. (1990) · Cited by 1,426 · see citing works
Irwin, R. S., Curley, F. J., & French, C. (1990) · American Review of Respiratory Disease · doi:10.1164/ajrccm/141.3.640 · Cited by 832 · see citing works
Institute of Medicine (1990) · National Academies Press eBooks · doi:10.17226/1626 · Cited by 807 · see citing works
ERS guidelines on the assessment of cough
Morice, A. H., Fontana, G. A., Belvisi, M. G., et al. (2007) · European Respiratory Journal · doi:10.1183/09031936.00101006 · Cited by 694 · see citing works
Self-citationThe diagnosis and management of chronic cough
Morice, A. H. (2004) · European Respiratory Journal · doi:10.1183/09031936.04.00027804 · Cited by 522 · see citing works
Self-citationIrwin, R. S., Corrao, W. M., & Pratter, M. R. (1981) · PubMed · doi:10.1164/arrd.1981.123.4.413 · Cited by 495 · see citing works
Eosinophilic Bronchitis Is an Important Cause of Chronic Cough
Brightling, C. E., WARD, R., Goh, K. L., Wardlaw, A. J., & Pavord, I. D. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.160.2.9810100 · Cited by 431 · see citing works
The spectrum and frequency of causes
Irwin, R. (1990) · Medical Entomology and Zoology · Cited by 427 · see citing works
Towards the simulation of clinical cognition
Pauker, S. G., Gorry, G. A., Kassirer, J. P., & Schwartz, W. B. (1976) · The American Journal of Medicine · doi:10.1016/0002-9343(76)90570-2 · Cited by 408 · see citing works
Googling for a diagnosis—use of Google as a diagnostic aid: internet based study
Tang, H., & Ng, J. (2006) · BMJ · doi:10.1136/bmj.39003.640567.ae · Cited by 386 · see citing works
A Pathogenic Triad in Chronic Cough
Palombini, B. C., Villanova, C. A., Araújo, E., et al. (1999) · CHEST Journal · doi:10.1378/chest.116.2.279 · Cited by 328 · see citing works
McGarvey, L. P., Heaney, L. G., Lawson, J., et al. (1998) · Thorax · doi:10.1136/thx.53.9.738 · Cited by 326 · see citing works
Mello, C. J. (1996) · Archives of Internal Medicine · doi:10.1001/archinte.1996.00440090103010 · Cited by 286 · see citing works
Capsaicin Cough Sensitivity Decreases with Successful Treatment of Chronic Cough
O’Connell, F., Thomas, V. E., Pride, N. B., et al. (1994) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.150.2.8049818 · Cited by 240 · see citing works
Chronic Cough with a History of Excessive Sputum Production
Smyrnios, N. A., Irwin, R. S., & Curley, F. J. (1995) · CHEST Journal · doi:10.1378/chest.108.4.991 · Cited by 215 · see citing works
Poe, R. H., Harder, R. V., Israel, R. H., et al. (1989) · CHEST Journal · doi:10.1378/chest.95.4.723 · Cited by 211 · see citing works
Morice, A. H. (2002) · Pulmonary Pharmacology & Therapeutics · doi:10.1006/pupt.2002.0352 · Cited by 191 · see citing works
Self-citationThe WWW of the World Wide Web: Who, What, and Why?
powell, J. A., & Clarke, A. (2002) · Journal of Medical Internet Research · doi:10.2196/jmir.4.1.e4 · Cited by 128 · see citing works
Chronic persistent cough in the community: a questionnaire survey
Everett, C. F., Kastelik, J. A., Thompson, R. H., et al. (2007) · Cough · doi:10.1186/1745-9974-3-5 · Cited by 124 · see citing works
Clinical history in gastroesophageal cough
Everett, C. F., & Morice, A. H. (2006) · Respiratory Medicine · doi:10.1016/j.rmed.2006.05.006 · Cited by 90 · see citing works
Self-citationRavid, D., Lishner, M., Lang, R., & Ravid, M. (1994) · The Journal of Clinical Pharmacology · doi:10.1002/j.1552-4604.1994.tb01989.x · Cited by 80 · see citing works
Chronic cough: bronchoscopy or pulmonary function testing?
Poe, R. H., Israel, R., Utell, M. J., et al. (1982) · PubMed · doi:10.1164/arrd.1982.126.1.160 · Cited by 74 · see citing works
Mello, C. J. (1996) · Archives of Internal Medicine · doi:10.1001/archinte.156.9.997 · Cited by 58 · see citing works
Eosinophilic Bronchitis is an Important Cause of Chronic Cough
McGarvey, L. P., Heaney, L. G., MacMahon, J., et al. (2000) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.161.5.16151b · Cited by 48 · see citing works
Marchesani, F., Cecarini, L., Pela, R., et al. (1998) · PubMed · Cited by 46 · see citing works
Persistent Cough in Nonsmokers
Hoffstein, V. (1994) · Canadian Respiratory Journal · doi:10.1155/1994/572613 · Cited by 43 · see citing works
Investigation and management of persistent dry cough
SIMPSON;, G., McGarvey, L. P., Heaney, L. G., et al. (1999) · Thorax · doi:10.1136/thx.54.5.468b · Cited by 24 · see citing works
Towards the Simulation of Clinical Cognition: Taking a Present Illness by Computer
Pauker, S. G., Gorry, G. A., Kassirer, J. P., et al. (1976) · Computers and medicine · doi:10.1007/978-1-4612-5108-8_7 · Cited by 18 · see citing works
Reproducibility and Sensitivity of the Hull Reflux Cough Questionnaire (HRCQ).
Faruqi, S., Brook, H., Hunter, V., et al. (2009) · doi:10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a5756 · Cited by 10 · see citing works
Googling for a diagnosis—use of Google as a diagnostic aid: internet based study
THIERS, B. H. (2007) · Yearbook of Dermatology and Dermatologic Surgery · doi:10.1016/s0093-3619(08)70567-7 · Cited by 5 · see citing works
General versus specific sino-nasal outcome measures
Fahmy, F., & McCombe, A. (2002) · Clinical Otolaryngology · doi:10.1046/j.1365-2273.2002.00586.x · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [17]17. Hoffstein V. Persistent cough in nonsmoker. Can Respir J 1994; 1: 40-47. Asthma 38.7% Rhinitis 15.2% Reflux 46.1% 18
Cited by
Sorted by citations
The Empirical Foundations of Telemedicine Interventions in Primary Care
Bashshur, R. L., Howell, J. D., Krupinski, E. A., Harms, K. M., Bashshur, N., & Doarn, C. R. (2016) · Telemedicine and e-Health · doi:10.1089/tmj.2016.0045 · Cited by 370 · see citing works
- Authors
- Dettmar, P. W., Strugala, V., Fathi, H., Dettmar, H. J., Wright, C., & Morice, A. H.
- Affiliations
- Technostics (United Kingdom) (GB)
- Castle Hill Hospital (GB)
- University of Hull (GB)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2009-03-26
- Volume
- 34
- Issue
- 4
- Pages
- 819-824
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2114052152
- Cited by
- 25
- References
- 34
- Citations by year
- 2024: 1 · 2023: 1 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 1 · 2013: 3
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- chronic cough, online diagnosis, reflux, asthma, rhinitis, diagnostic algorithm, patient-provider communication
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Algorithms, Chronic Disease, Cough, Female, Follow-Up Studies, United Kingdom, Humans, Male, Middle Aged, Pilot Projects, Surveys and Questionnaires, User-Computer Interface, Reproducibility of Results, Program Evaluation, Patient Satisfaction, Practice Guidelines as Topic, Evidence-Based Medicine, Internet, Young Adult
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