Validation of a modified ECRHS questionnaire for diagnosing asthma in patients with chronic cough

Shin, Ji Young; Lee, Jeong Eun; Park, Ji Won; Jung, Sun Young; Yoo, Su Jin; Yoon, Ji Hyun; Park, Hee Sun; Kim, Sun Young; Kim, Ju Ock

Abstract

BACKGROUND/AIMS
Chronic cough may be the only manifestation of asthma. This study prospectively evaluated the validation of a modified European Community Respiratory Health Survey (ECRHS) questionnaire (including postnasal drip and GERD) in patients with chronic cough.
METHODS
We recruited patients with a chronic cough exceeding 8 weeks from Oct. 2004 to March 2008. The patients had undergone an assessment using the modified ECRHS questionnaire, methacholine challenge test, chest PA, and PNS series, as well as the MAST and skin prick test in some patients.
RESULTS
A total of 1518 patients were recruited. A total of 511 patients (33.6%) were physician diagnosed with asthma. Wheezing (53%, odds ratio [OR]: 2.989), nocturnal cough or dyspnea (57.3%,OR: 1.751), resting dyspnea (43.8%, OR: 2.216), post-exercise dyspnea (63.4%,OR: 2.297), esophageal reflux symptoms (34.1%, OR: 1.107) and postnasal drip (13.1%, OR: 1.116) are symptoms that have been reported. As the number of asthmatic symptoms included in the questionnaire increased, the number of patients diagnosed with asthma by a physician increased. The correlation between bronchial hyperresoponsiveness (BHR) and physician diagnosed asthma was evaluated by the area under the receiver operator characteristic (ROC) curve. The questionnaire was more correlated with BHR than with physician diagnosed asthma (area: 0.852 vs. 0.631).
CONCLUSIONS
The Modified ECRHS questionnaire is an available method to assist in the diagnosis of asthma and to evaluate BHR in patients with chronic cough.