SUBJECTIVE SCORING OF COUGH IN CHILDREN - PARENT-COMPLETED VS CHILD-COMPLETED DIARY CARDS VS AN OBJECTIVE METHOD

Cough is often used as an outcome measure, although the reporting of c ough is unreliable. Using a 24 h ambulatory cough meter to measure cou gh frequency, the aim of this study was to compare: 1) the correlation of child-completed diary cards to the objective measurement, with tha t of parent-completed diary cards; and 2) the visual analogue scale (V AS) to the verbal category descriptive (VCD) score, The cough meter co nsisted of a previously validated Holter monitor and a cough processor . Eighty four children (39 with recurrent cough and 45 controls, aged 6-17 yrs) used a cough meter at least once, Thirty three subjects used the cough meter twice, Parents and children completed separate diary cards using the VAS and VCD scores. The strength of the relationship b etween the subjective scores and the subjective recordings was analyse d by spearman's rank correlation coefficient, For daytime cough, child -completed diary cards and the VCD correlated better to the objective measurement than parent-completed diary cards and the VAS, respectivel y. In subjects that used the cough meter twice, the difference between the cough frequency correlated to the difference in the subjective sc ores, The confidence intervals for the correlation coefficients were w ide, The agreement between the objective and subjective presence of da ytime cough was good but that for night-time cough was poor, We conclu de that the severity of cough defined on diary cards may not represent cough frequency. Objective readings are first choice but currently no t yet practical, The verbal category descriptive diary card completed by children and assisted by parents has the highest correlation to cou gh frequency measured objectively.