Etiologies of Chronic Cough in Pediatric Cohorts: CHEST Guideline and Expert Panel Report

Anne B. Chang, John Oppenheimer, Miles Weinberger, Cameron C. Grant, Bruce K. Rubin, Richard S. Irwin, Kenneth W. Altman, Elie Azoulay, Alan F. Barker, Surinder S. Birring, Fiona Blackhall, Donald C. Bolser, hristopher Brightling, Priscilla Callahan-Lyon, Paul Davenport, Satoru Ebihara, Ali A. El Solh, Patricio Escalante, Stephen K. Field, Dina FisherCynthia T. French, Susan M. Harding, Peter Gibson, Philip Gold, Anthony Harnden, Adam T. Hill, Richard S. Irwin, Joanne Kavanagh, Karina A. Keogh, Kefang Lai, Andrew P. Lane, J. Mark Madison, Mark A. Malesker, Stuart Mazzone, Alex Molassoitis, M. Hassan Murad, Mangala Narasimhan, Huong Q. Nguyen, Peter Newcombe, John Oppenheimer, Marcos I. Restrepo, Mark Rosen, Bruce Rubin, Jay H. Ryu, Susan M. Tarlo, Julie Turmel, Anne E. Vertigan, Miles Weinberger, Kelly Weir

    Research output: Contribution to journalArticlepeer-review


    Background: There is no published systematic review on the etiologies of chronic cough or the relationship between OSA and chronic cough in children aged ≤ 14 years. We thus undertook a systematic review based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format. The KQs follow: Among children with chronic (> 4 weeks) cough (KQ 1) are the common etiologies different from those in adults? (KQ 2) Are the common etiologies age or setting dependent, or both? (KQ 3) Is OSA a cause of chronic cough in children? 

    Methods: We used the CHEST Expert Cough Panel's protocol and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework. Data from the systematic reviews in conjunction with patients’ values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus. 

    Results: Combining KQs 1 and 2, we found moderate-level evidence from 10 prospective studies that the etiologies of cough in children are different from those in adults and are setting dependent. Data from three studies found that common etiologies of cough in young children were different from those in older children. However, data relating sleep abnormalities to chronic cough in children were found only in case studies. 

    Conclusions: There is moderate-quality evidence that common etiologies of chronic cough in children are different from those in adults and are dependent on age and setting. As there are few data relating OSA and chronic cough in children, the panel suggested that these children should be managed in accordance with pediatric sleep guidelines.

    Original languageEnglish
    Pages (from-to)607-617
    Number of pages11
    Issue number3
    Publication statusPublished - 1 Sep 2017


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