Development and Validation of Cough Hypersensitivity Assessment Test

IF 6.6 1区医学 Q1 ALLERGY Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-05-01 Epub Date: 2025-03-14 DOI:10.1016/j.jaip.2025.03.010

Zien Feng MD , Fang Yi MD, PhD , Wenzhi Zhan MD, PhD , Ruchong Chen MD, PhD , Wanjun Wang MD, PhD , Surinder S. Birring MD , Kefang Lai MD, PhD

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Abstract

Background

Cough hypersensitivity is an important clinical and pathophysiologic feature of chronic cough, which involves chemical, mechanical, and thermal stimuli and sensory dysfunction. Currently, there is a need for a comprehensive method to evaluate cough hypersensitivity.

Objective

To develop and validate a questionnaire to assess the degree of cough hypersensitivity.

Methods

The initial items of the Cough Hypersensitivity Assessment Test (CHAT) were made based on a literature review, experts’ opinions, and clinical practice. Items were reduced after investigation involving patients with chronic cough. Dimensional allocation, internal reliability, test-retest reliability, construct validity, responsiveness, and cutoff value were determined in the final stage.

Results

The final version of CHAT on a 5-point Likert scale (0-4) includes 18 items consisting of three dimensions: environmental triggers, daily life triggers, and tussive symptoms, with total score ranging from 0 to 72. There was significant difference in CHAT-18 scores between patients and healthy controls (P < .001). Cronbach α for CHAT was 0.832 and intraclass correlation coefficient for CHAT was 0.884. Construct validity was demonstrated with a multitrait-multimethod matrix. There was good responsiveness after treatment. The cutoff value of CHAT was 18 for cough hypersensitivity. There was a mild to moderate correlation between capsaicin cough sensitivity and tussive symptoms and the total score of CHAT.

Conclusions

The CHAT comprehensively covers a range of cough triggers and shows robust internal reliability, test-retest reliability, construct validity, and responsiveness. This may be useful for measuring cough hypersensitivity.

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咳嗽超敏反应评估试验（CHAT）的研制与验证。

背景：咳嗽超敏反应是慢性咳嗽的重要临床和病理生理特征，涉及化学、机械、热刺激和感觉功能障碍。目前，缺乏一种评价咳嗽过敏的综合方法。目的：本研究的目的是制定并验证一份评估咳嗽过敏程度的问卷。方法：在文献查阅、专家意见和临床实践的基础上，制定咳嗽超敏反应评价试验（CHAT）的初始项目，并对慢性咳嗽患者进行调查后减少项目。在最后阶段确定维度分配、内部信度、重测信度、构念效度、反应性和截止值。结果：最终版本的CHAT采用5点李克特量表（0-4），包括18个项目，由环境触发因素、日常生活触发因素和咳嗽症状3个维度组成，总分0-72分。患者与健康对照组的CHAT-18评分差异有统计学意义（p < 0.001）。CHAT的Cronbach’s alpha值为0.832。CHAT的类内相关系数为0.884。建构效度以多特质-多方法矩阵证明。治疗后反应性良好。咳嗽超敏反应的CHAT临界值为18。辣椒素咳嗽敏感性与咳嗽症状及CHAT总分有轻度至中度相关性。结论：咳嗽超敏反应评估测验全面覆盖了一系列咳嗽触发因素，具有良好的内部信度、重测信度、构效度和反应性。这可能是有用的测量咳嗽过敏。

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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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.