Real-world retrospective study on the characteristics, management and outcomes of patients presenting to a tertiary chronic cough clinic
Bibliographic record
Abstract
Background: Chronic cough (CC), defined as cough lasting longer than 8 weeks, is among the commonest reasons for referral to a respiratory specialist. The global prevalence of CC is estimated to be nearly 10%. However, it is unclear what proportion have refractory chronic cough (RCC) after guideline-based investigations and management. Objective: To describe the characteristics, management and outcomes of patients referred to a cough clinic. Methods: A retrospective review of all patients referred to the cough clinic at McMaster University Medical Centre between January 2020 – May 2024. Data includes demographics, co-morbidities, investigations, and response to therapy. Results: Data from 364 patients with CC was evaluated. At the initial visit, 65% of patients reported being trialed on at least one form of cough treatment previously. In 93% of patients presenting with CC, an underlying condition was identified, including asthma, eosinophilic or neutrophilic bronchitis, ILD, GERD and COPD. The majority of patients were diagnosed with cough hypersensitivity syndrome (31%), and 35% had multifactorial causes of CC. Of those who received treatment, 237 (65%) noted an improvement in their symptoms. Notably, 191 (52%) felt that their cough had resolved or was sufficiently controlled with therapy. Of patients offered treatment, 82 (13%) reported an adverse event related to therapy, and 69 (84%) required therapy to be changed or discontinued as a result. Conclusion: The majority of CC patients referred to a specialist clinic had identifiable underlying conditions and approximately half responded well to treatment, leaving nearly 50% with RCC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".