Evidence map›Paper›PMID 27614002›Full record

GuidelineChest2016

Chronic Cough Due to Gastroesophageal Reflux in Adults: CHEST Guideline and Expert Panel Report.

Peter J Kahrilas, Kenneth W Altman, Anne B Chang, Stephen K Field, Susan M Harding, Andrew P Lane, Kaiser Lim, Lorcan McGarvey, Jaclyn Smith, Richard S Irwin and 1 more

Registry-linked trialOpen access · greenAbstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Chest, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04984304 (Individualized Diagnosis and Treatment of Extraesophageal Reflux in Patients With Chronic Cough), which is not on this map. Cited by 88 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 4 pooled it
13.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04984304 naunknown statusnot on this mapstarted 2021, after this paper: background citation

Individualized Diagnosis and Treatment of Extraesophageal Reflux in Patients With Chronic Cough

TypeinterventionalSponsorUniversity Hospital OstravaRan2021 to 2024Enrolled150ConditionsChronic Cough, Extraesophageal Reflux, Laryngopharyngeal Reflux, AllergyArmsLifestyle modifications and Antireflux diet, Extraesophageal reflux diagnostic
3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 4 syntheses or guidelines pooled it, 223 citations in OpenAlex.

  1. Pooled it
  2. Meta-analysis of Proton Pump Inhibitors in the Treatment of Pharyngeal Reflux Disease.Computational and mathematical methods in medicine · 2022
    Pooled it
  3. Guideline
  4. Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Article
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  11. Review
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  16. Review
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28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 13 institutions in 4 countries.

Peter J KahrilasDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: p-kahrilas@northwestern.edu.
Kenneth W AltmanBobby R. Alford Department of Otolaryngology, Baylor College of Medicine, Houston, TX.
Anne B ChangMenzies School of Health, Research and Respiratory Department, Lady Cilento Children's Hospital, Queensland University of Technology, Queensland, Australia.
Stephen K FieldDivision of Respiratory Medicine, Department of Medicine, Cummings School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
Susan M HardingDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL.
Andrew P LaneDivision of Rhinology and Sinus Surgery, Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
Kaiser LimDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic Rochester, Rochester, MN.
Lorcan McGarveyDepartment of Medicine, Queen's University Belfast, Belfast, Northern Ireland.
Jaclyn SmithDepartment of Medicine, University of Manchester and University Hospital of South Manchester, England.
Richard S IrwinUniversity of Massachusetts Medical School, Worcester, MA.
CHEST Expert Cough Panel
Northwestern University · USUniversity of Alabama at Birmingham · USBaylor College of Medicine · USJohns Hopkins University · USMayo Clinic · USQueen's University Belfast · GBUniversity of Massachusetts Chan Medical School · USAlberta Health Services · CAMenzies School of Health Research · AUQueensland Children’s Hospital · AUSewanee: The University of the South · USUniversity of Calgary · CAUniversity of Manchester · GB

Funding

THE ESOPHAGOGASTRIC JUNCTION IN HEALTH AND DISEASER01DK056033 · NIDDK · NORTHWESTERN UNIVERSITY AT CHICAGO · PI KAHRILAS, PETER JAMES · 2001 to 2015
$4.1M
Reflexes and Supraesophageal Consequences Reflux DiseaseR01HL083192 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI CANNING, BRENDAN J · 2006 to 2010
$1.6M
Cancer Research UK 20465Medical Research Council G0701918Medical Research Council MR/K015141/1NHLBI NIH HHS R01 HL083192NIDDK NIH HHS R01 DK056033
6 · The paper itself

Abstract

backgroundWe updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome.

methodsTwo population, intervention, comparison, outcome (PICO) questions were addressed by systematic review: (1) Can therapy for gastroesophageal reflux improve or eliminate cough in adults with chronic and persistently troublesome cough? and (2) Are there minimal clinical criteria to guide practice in determining that chronic cough is likely to respond to therapy for gastroesophageal reflux?

resultsWe found no high-quality studies pertinent to either question. From available randomized controlled trials (RCTs) addressing question #1, we concluded that (1) there was a strong placebo effect for cough improvement; (2) studies including diet modification and weight loss had better cough outcomes; (3) although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, proton pump inhibitors (PPIs) demonstrated no benefit when used in isolation; and (4) because of potential carryover effect, crossover studies using PPIs should be avoided. For question #2, we concluded from the available observational trials that (1) an algorithmic approach to management resolved chronic cough in 82% to 100% of instances; (2) cough variant asthma and upper airway cough syndrome (UACS) (previously referred to as postnasal drip syndrome) from rhinosinus conditions were the most commonly reported causes; and (3) the reported prevalence of reflux-cough syndrome varied widely.

conclusionsThe panelists (1) endorsed the use of a diagnostic/therapeutic algorithm addressing causes of common cough, including symptomatic reflux; (2) advised that although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, PPIs demonstrated no benefit when used in isolation; and (3) suggested that physiological testing be reserved for refractory patients being considered for antireflux surgery or for those in whom there is strong clinical suspicion warranting diagnostic testing.

Indexed as

AdultChronic DiseaseCoughEvidence-Based MedicineFemaleGastroesophageal RefluxHumanscoughevidence-based medicinegastroesophageal reflux diseaseguidelines

Identifiers

PMID27614002
PMCPMC6026249
OpenAlexW2515863549

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.