Development and validation of the COugh Assessment Test (COAT)

Abstract

Background and objective: A cough-specific quality-of-life questionnaire is recommended to assess the impact of cough; however, a simple instrument to quantify cough is required for everyday clinical practice. This study was aimed to develop a short patient-completed questionnaire (COugh Assessment Test, COAT). Methods: The COAT was developed and validated by comparison with the Korean version of Leicester Cough Questionnaire (K-LCQ) and cough numeric rating scale (NRS, 0–10, 11-point scale) for chronic cough patients. Results: Item selection identified five items regarding cough frequency, daily activity, sleep disturbance, fatigue and cough hypersensitivity (0–4 scaling of items, 0–20 score range) through reliability test cohort (n = 78). Test–retest reliability was strong (intra-class correlation coefficient = 0.88). The final COAT was compared with K-LCQ and cough NRS in a validation cohort (n = 323). In Rasch analysis, COAT fitted well to a unidimensional model. Pearson correlations of COAT versus K-LCQ (i) before treatment, (ii) after treatment; COAT versus cough NRS (iii) before treatment, (iv) after treatment; (v) delta-COAT versus delta-cough NRS, (vi) delta-COAT versus delta-K-LCQ were (i) −0.71, (ii) −0.81, (iii) 0.69, (iv) 0.82, (v) −0.66 and (vi) 0.72, respectively. Conclusion: The COAT is a useful, simple questionnaire for assessing and monitoring cough. © 2019 Asian Pacific Society of Respirology