Cough in Adults with Undiagnosed Respiratory Symptoms
Bibliographic record
Abstract
Abstract Rationale Cough is a common symptom of undiagnosed respiratory conditions. Objectives To investigate cough in adults with undiagnosed respiratory symptoms and its association with quality of life (QoL), sleep quality, and healthcare utilization for respiratory illness. Methods We used a case-finding strategy to find community-dwelling adults with respiratory symptoms but no previous history of diagnosed lung disease. Pre and postbronchodilator spirometry determined if participants met diagnostic criteria for asthma, chronic obstructive pulmonary disease (COPD), or preserved ratio impaired spirometry, or if they had normal spirometry. Twelve questions from the Asthma Screening Questionnaire, COPD Assessment Test, and the St. George’s Respiratory Questionnaire were used to develop a cough score. The 36-Item Short Form Survey and Global Sleep Assessment Questionnaire were used to assess QoL and sleep quality, respectively. Results Adults with undiagnosed respiratory symptoms (n = 2,857; mean score, 57.8; 95% confidence interval [CI], 56.9 to 58.6) reported higher cough scores than age-matched control subjects (n = 231; mean score, 17.7; 95% CI, 15.6 to 19.8). Participants found to have asthma (n = 265; mean score, 61.0; 95% CI, 58.2 to 63.7) and COPD (n = 330; mean score, 61.8; 95% CI, 59.3 to 64.3) had higher cough scores than those with preserved ratio impaired spirometry (n = 172; mean score, 54.5; 95% CI, 51.1 to 58.0) or normal spirometry (n = 2,090; mean score, 57.0; 95% CI, 56.0 to 58.0). Higher cough scores were associated with decreased QoL (lower 36-Item Short Form Survey score; regression coefficient, −0.19; 95% CI, −0.22 to −0.17; P < 0.001), worse sleep quality (higher Global Sleep Assessment Questionnaire score; regression coefficient, 0.16; 95% CI, 0.14 to 0.18; P < 0.001), and higher healthcare utilization for respiratory illness (incidence rate ratio, 1.007; 95% CI, 1.004 to 1.010; P < 0.001). Conclusions In adults with undiagnosed respiratory symptoms, cough was most severe in those with undiagnosed asthma or COPD and was independently associated with worse QoL, impaired sleep quality, and higher healthcare utilization for respiratory illness.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".