Evidence map›Paper›PMID 30553636›Full record

Observational studyThe American journal of emergency medicine2019

Clinical management decisions for adults with prolonged acute cough: Frequency and associated factors.

Christian S Marchello, Mark H Ebell, Brian McKay, Ye Shen, Eric T Harvill, Christopher C Whalen

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in The American journal of emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 33% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Physical Disorders are Associated with Health Risk Behaviors in Chinese Adolescents: A Latent Class Analysis.International journal of environmental research and public health · 2020
    Article
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

6 authors at 1 institution in 1 country.

Christian S MarchelloDepartment of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA. Electronic address: csm44479@uga.edu.
Mark H EbellDepartment of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA. Electronic address: ebell@uga.edu.
Brian McKayDepartment of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
Ye ShenDepartment of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
Eric T HarvillDepartment of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
Christopher C WhalenDepartment of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
University of Georgia · US

Funding

Community Transmission of Tuberculosis Urban AfricaR01AI093856 · NIAID · UNIVERSITY OF GEORGIA · PI WHALEN, CHRISTOPHER C. · 2012 to 2021
$5.7M
The Microbiota Pathogen CompetitionR01GM113681 · NIGMS · UNIVERSITY OF GEORGIA · PI HARVILL, ERIC T · 2015 to 2018
$1.3M
Bordetella sp. Versus MicrobiotaR56AI107016 · NIAID · PENNSYLVANIA STATE UNIVERSITY, THE · PI HARVILL, ERIC T · 2014 to 2014
$377k
NIAID NIH HHS R01 AI093856NIAID NIH HHS R56 AI107016NIGMS NIH HHS R01 GM113681
6 · The paper itself

Abstract

backgroundUncomplicated episodes of prolonged acute cough are usually viral and self-limited, but despite evidence and recommendations to the contrary, they are often treated with antibiotics.

methodsMixed cross-sectional and prospective observational study of adults 18 years or older presenting to two urgent care centers with a cough of 7 to 56 days as their chief complaint. Factors associated with cough duration and clinical decisions were analyzed by univariate and multivariate logistic regression.

resultsOf the 125 enrolled patients, 118 (94%) received an antibiotic, 97 (78%) a cough suppressant, 87 (70%) a systemic corticosteroid, and 39 (31%) a chest X-ray (CXR). Longer duration of cough was associated with the presence of self-reported wheezing or noises (adjusted odds ratio 6.29, 95% CI 1.36-29.16) while the presence of both wheezing and crackles on a clinician chest exam was associated with shorter duration (aOR 0.03, 95% CI 0.00-0.27). A clinician was more likely to order a CXR in patients with dyspnea (aOR 3.01, 95% CI 1.21-7.49), less likely to prescribe a systemic corticosteroid in patients with crackles (aOR 0.27, 95% CI 0.09-0.82), and more likely to prescribe a cough suppressant to older patients (1.04 per additional year of age, 95% CI 1.01-1.07).

conclusionsSystemic corticosteroids and cough suppressants are being prescribed at high rates in patients with uncomplicated acute cough in the urgent care setting. Additional studies to determine if similar rates are seen in other urgent care centers, or in other contemporary ambulatory settings are warranted.

Indexed as

Clinical Decision-MakingAdrenal Cortex HormonesAdultAmbulatory Care FacilitiesAnti-Bacterial AgentsAntitussive AgentsAuscultationBronchitisCoughDyspneaFemaleHumansLogistic ModelsMaleMultivariate AnalysisRadiography, ThoracicAdrenal Cortex HormonesAnti-Bacterial AgentsAntitussive AgentsClinical managementCorticosteroidsCoughUrgent care

Identifiers

PMID30553636
PMCPMC7394261
OpenAlexW2904725162

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.