Publications by authors named "Cynthia T French"
Background: Several recent cough guidelines have advised consideration of occupational or environmental causes for chronic cough, but it is unclear how frequently this recommendation has been routinely applied. Therefore, we undertook a systematic review to address this aspect.
Methods: Cough guidelines and protocols were reviewed to identify recommendations for assessment of occupational and environmental aspects of chronic cough.
Background: We conducted a systematic review on the management of psychogenic cough, habit cough, and tic cough to update the recommendations and suggestions of the 2006 guideline on this topic.
Methods: We followed the American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework. The Expert Cough Panel based their recommendations on data from the systematic review, patients' values and preferences, and the clinical context.
Background: Successful management of chronic cough has varied in the primary research studies in the reported literature. One of the potential reasons relates to a lack of intervention fidelity to the core elements of the diagnostic and/or therapeutic interventions that were meant to be used by the investigators.
Methods: We conducted a systematic review to summarize the evidence supporting intervention fidelity as an important methodologic consideration in assessing the effectiveness of clinical practice guidelines used for the diagnosis and management of chronic cough.
Background: Since the publication of the 2006 American College of Chest Physicians (CHEST) cough guidelines, a variety of tools has been developed or further refined for assessing cough. The purpose of the present committee was to evaluate instruments used by investigators performing clinical research on chronic cough. The specific aims were to (1) assess the performance of tools designed to measure cough frequency, severity, and impact in adults, adolescents, and children with chronic cough and (2) make recommendations or suggestions related to these findings.
View Article and Find Full Text PDFBackground: This series of guidance documents on cough, which will be published over time, is a hybrid of two processes: (1) evidence-based guidelines and (2) trustworthy consensus statements based on a robust and transparent process.
Methods: The CHEST Guidelines Oversight Committee selected a nonconflicted Panel Chair and jointly assembled an international panel of experts in each clinical area with few, if any, conflicts of interest. PICO (population, intervention, comparator, outcome)-based key questions and parameters of eligibility were developed for each clinical topic to inform the comprehensive literature search.
This overview will demonstrate that cough is a common and potentially expensive health-care problem. Improvement in the quality of care of those with cough has been the focus of study for a variety of disciplines in medicine. The purpose of the Cough Guideline and Expert Panel is to synthesize current knowledge in a form that will aid clinical decision-making for the diagnosis and management of cough across disciplines and also identify gaps in knowledge and treatment options.
View Article and Find Full Text PDFThere is wide acceptance of the concept that interdisciplinary collaboration is an essential building block for successful health-care teams. This belief is grounded in our understanding of how teams function to address complex care needs that change with acute illness or injury. This general agreement has been validated in studies that have reported favorable outcomes associated with successfully implementing interdisciplinary models of health-care delivery in non-critical care settings.
View Article and Find Full Text PDFObjectives: We assessed the reliability and validity of two measures of change, one retrospective (the Global Rating of Change Scale [GRCS]) and one prospective (the Punum Ladder), and the relative utility of the two methods of assessing change and establishing the minimal important difference (MID) of the Cough Quality of Life Questionnaire (CQLQ), a reliable and valid cough-specific quality-of-life (QoL) instrument.
Study Design And Setting: A prospective, longitudinal study assessing the change in cough-related QoL over 6 months in participants with chronic cough was carried out in a tertiary care cough clinic. Before seeing a physician, subjects completed eight Punum Ladders and the CQLQ.
Study Objectives: To determine whether the health-related quality of life (HRQOL) of women and men is adversely affected by acute cough (AC), affected differently by AC, or affected differently by AC and chronic cough (CC).
Design: Analysis of consecutively and prospectively collected AC data from two time periods, and previously prospectively and consecutively collected CC data that had not been previously analyzed. When no differences were found in the two cohorts of acute coughers, as was the case in the greatest majority of comparisons, the two samples were pooled, treated as one sample of acute coughers, and compared with chronic coughers.
Study Objectives: To confirm that more women than men who complain of chronic cough seek medical attention, to determine whether the health-related quality of life (HRQOL) of these women is more adversely affected than men, and to determine whether there are gender differences in the ways that chronic cough adversely affects HRQOL.
Design: Analysis of previously, prospectively collected data, but not previously analyzed or reported data, plus additional prospectively collected data to enrich the database to make meaningful gender comparisons.
Setting: Cough clinic in an academic, tertiary care medical center.
As coughing can cause profound physical and psychosocial complications, it has the potential to lead to a decrease in health-related quality of life (HRQoL). Two studies have prospectively shown that cough can adversely affect HRQoL. The first utilized the Sickness Impact Profile, a non-illness specific measure of health-related dysfunction that measured the effect of patients' health dysfunction on usual daily activities; it has not been psychometrically tested to assess the effects of cough.
View Article and Find Full Text PDFObjective: To examine the effects of a mechanical ventilation weaning management protocol that was implemented as a hospital-wide, quality improvement program on clinical and economic outcomes.
Design: Prospective, before-and-after intervention study. Data from a preimplementation year are compared with those of the first 2 yrs after protocol implementation.
Background: While medical therapy may fail to improve cough due to gastroesophageal reflux disease (GERD), it is not known if inadequate esophageal acid suppression is responsible.
Methods: In a prospective, before-and-after interventional trial, we assessed the effects of antireflux surgery in eight patients whose chronic coughs were due to GERD resistant to intensive medical therapy. All patients met a profile predicting that cough was likely due to GERD and had an initial positive 24-h esophageal pH monitoring study, and then underwent serial 24-h esophageal pH monitoring on gradually intensified medical therapy until the percentage of time that esophageal pH was < 4 was zero and there were no acid reflux events > 4 min.
Study Objective: To psychometrically evaluate a cough-specific quality-of-life questionnaire (CQLQ) in adults.
Design: Prospective evaluation of CQLQ using three different cohorts of adult subjects with cough.
Setting: Academic tertiary-care ambulatory medical facilities.