Mann Jennifer, Barnes Hayley, Lew Jeremy, Khor Yet H, Goh Nicole, Holland Anne E
Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia
The Institute for Breathing and Sleep, Melbourne, Australia.
Eur Respir Rev. 2025 Jul 9;34(177). doi: 10.1183/16000617.0206-2024. Print 2025 Jul.
Validated and reliable patient-reported outcome measures (PROMs) are recommended to assess the severity and impact of cough in interstitial lung disease (ILD). We systematically reviewed the literature to identify PROMs for cough in ILD, examining their psychometric properties.
We searched four databases from inception to 10 January 2025. English-language original articles that described the use of a PROM to measure cough in adults with ILD and addressed the psychometric properties, method of administration or results of usability testing were selected.
21 PROMs were evaluated in 35 studies, including 14 in idiopathic pulmonary fibrosis (IPF) and seven in other ILDs, eight cough-specific PROMs, and 13 disease-specific PROMs with a domain for cough. No tool had sufficient evidence for more than 5/7 of the psychometric properties evaluated. There was evidence for content validity for four PROMs in IPF (A Tool to Assess Quality of Life in Idiopathic Pulmonary Fibrosis (ATAQ-IPF), the Cough and Sputum Assessment Questionnaire (CASA-Q), Evaluating Respiratory Symptoms: COPD (E-RS™:COPD) and the Living with Idiopathic Pulmonary Fibrosis Questionnaire (L-IPF)). Only one study evaluated convergent validity using objective cough monitoring, demonstrating high validity for the Leicester Cough Questionnaire (LCQ) (r=-0.74- -0.80) and cough visual analogue scale (VAS) (r=0.80). Acceptable internal consistency (α>0.7) was demonstrated for 10 PROMs (ATAQ-IPF, the Cross-Atlantic modification of ATAQ-IPF, the Chinese version of ATAQ-IPF, CASA-Q, E-RS™:COPD, LCQ, L-IPF, the IPF-specific version of St George's Respiratory Questionnaire (SGRQ), the modified version of the Edmonton System Assessment System and SGRQ). The cough VAS demonstrated good predictive validity and L-IPF was responsive to ILD-specific therapies, with effect sizes ranging from 0.32 to 0.44.
Evidence supporting the measurement properties of available PROMs for cough in ILD is limited. Further validation of existing instruments and the development of new disease-specific PROMs are needed.
推荐使用经过验证且可靠的患者报告结局测量工具（PROMs）来评估间质性肺病（ILD）中咳嗽的严重程度和影响。我们系统地回顾了文献，以确定ILD中咳嗽的PROMs，并检查其心理测量特性。
我们检索了四个数据库，检索时间从数据库创建至2025年1月10日。选择了描述使用PROM测量ILD成年患者咳嗽情况并涉及心理测量特性、施测方法或可用性测试结果的英文原创文章。
35项研究评估了21种PROMs，其中14项针对特发性肺纤维化（IPF），7项针对其他ILD，8种是咳嗽特异性PROMs，13种是具有咳嗽领域的疾病特异性PROMs。没有工具对于所评估的超过5/7的心理测量特性有充分证据。有证据表明IPF中的四种PROMs具有内容效度（特发性肺纤维化生活质量评估工具（ATAQ-IPF）、咳嗽和痰液评估问卷（CASA-Q）、评估呼吸系统症状：慢性阻塞性肺疾病（E-RS™:COPD）和特发性肺纤维化生活问卷（L-IPF））。只有一项研究使用客观咳嗽监测评估了收敛效度，证明莱斯特咳嗽问卷（LCQ）（r=-0.74--0.80）和咳嗽视觉模拟量表（VAS）（r=0.80）具有高效度。10种PROMs表现出可接受的内部一致性（α>0.7）（ATAQ-IPF、ATAQ-IPF的跨大西洋修订版、ATAQ-IPF中文版、CASA-Q、E-RS™:COPD、LCQ、L-IPF、圣乔治呼吸问卷（SGRQ）的IPF特异性版本、埃德蒙顿系统评估系统修订版和SGRQ）。咳嗽VAS表现出良好的预测效度，L-IPF对ILD特异性治疗有反应，效应大小范围为0.32至0.44。
支持现有ILD咳嗽PROMs测量特性的证据有限。需要对现有工具进行进一步验证，并开发新的疾病特异性PROMs。
