Departments of Allergy and Research and Evaluation, Kaiser Permanente Southern California, San Diego and Pasadena, CA.
Center for Observational and Real-World Evidence (CORE), Merck & Co, Inc, Kenilworth, NJ.
Perm J. 2020 Dec;24:1-3. doi: 10.7812/TPP/20.022.
International Classification of Diseases-9/10 codes for chronic cough (CC) do not exist, limiting investigation.
To develop a computerized algorithm to determine CC prevalence and its characteristics.
This observational study using administrative data identified hierarchically patients aged 18 to 85 years with CC from 2013 to 2016. First, a specialist-diagnosed CC group was identified using an internal CC encounter code during an outpatient visit to a pulmonologist, allergist, otolaryngologist, or gastroenterologist. Subsequently, an event-diagnosed CC group was identified based on clinical notes through natural language processing, ICD-9/ICD-10 cough codes, and dispensed antitussives.
Prevalence of CC and comparison of clinical characteristics between specialist-diagnosed and event-diagnosed CC subgroups.
A total of 50,163 patients with CC of more than 8 weeks were identified. Of these, 11,290 (22.5%) were specialist diagnosed, and 38,873 (77.5%) were event diagnosed. The CC cohort was 57.4 ± 16.5 years of age; 67.6% were female. The overall prevalence was 1.04% (95% confidence interval = 1.03-1.06) in 2016. Prevalence in 2016 was higher in female patients (1.21%) than in male patients (0.81%), higher in patients aged 65 to 85 years (2.2%) than in patients aged 18 to 44 years (0.43%), and higher in Blacks (1.38%) than in Whites (1.21%). Compared with patients with event-diagnosed CC, patients with specialist-diagnosed CC exhibited significantly higher frequencies of laboratory tests and respiratory and nonrespiratory comorbidities and dispensed medication and lower frequency of pneumonia, all-cause and respiratory-cause emergency department visits and hospitalizations, and dispensed antitussives.
We identified a CC cohort using electronic data in a managed care organization. Prevalences varied by sex, age, and ethnicity. Clinical characteristics varied between specialist-diagnosed and event-diagnosed CC.
国际疾病分类第 9 版/第 10 版（ICD-9/10）中不存在用于慢性咳嗽（CC）的代码，这限制了对其的研究。
开发一种用于确定 CC 患病率及其特征的计算机算法。
本观察性研究使用管理数据，从 2013 年至 2016 年，按年龄（18-85 岁）对门诊就诊于肺病专家、过敏专家、耳鼻喉科专家或胃肠病专家的疑似 CC 患者进行分层，识别出慢性咳嗽患者。首先，使用内部 CC 就诊代码识别出经专科医生诊断的 CC 患者。随后，通过自然语言处理、ICD-9/ICD-10 咳嗽代码和开具镇咳药，从临床记录中识别出事件诊断的 CC 患者。
CC 的患病率，以及专科医生诊断的 CC 亚组和事件诊断的 CC 亚组之间的临床特征比较。
共确定了 50163 名患有持续时间超过 8 周的 CC 患者。其中，11290 名（22.5%）经专科医生诊断，38873 名（77.5%）经事件诊断。CC 患者队列的平均年龄为 57.4±16.5 岁，其中 67.6%为女性。2016 年 CC 的总体患病率为 1.04%（95%置信区间=1.03-1.06）。2016 年女性患者的患病率（1.21%）高于男性患者（0.81%），65-85 岁患者（2.2%）高于 18-44 岁患者（0.43%），黑种人（1.38%）高于白人（1.21%）。与事件诊断的 CC 患者相比，专科医生诊断的 CC 患者的实验室检查、呼吸道和非呼吸道合并症以及开具的药物更为频繁，而肺炎、所有原因和呼吸道原因的急诊就诊和住院治疗以及开具的镇咳药更为少见。
我们在一家管理式医疗组织中使用电子数据识别出 CC 患者队列。患病率因性别、年龄和种族而异。专科医生诊断的 CC 和事件诊断的 CC 的临床特征存在差异。
