Cough counting app can be point of care test for asthma attacks

Asthma exacerbations may be self diagnosed by patients using a smartphone-based algorithm that combines cough counting and patient-reported symptoms, WA researchers have shown.

A team at Curtin University in Perth assessed the  ResApp Health algorithm in  a study involving 119 asthma patients over the age of 12 years, of who 46 had clinically confirmed asthma exacerbations and 73 had controlled asthma.

The smartphone-based algorithm was used to analyse five cough events and five patient-reported features of age, fever, acute or productive cough and wheeze,  to detect asthma exacerbations.

When compared with expert clinical diagnosis the algorithm had a positive percent agreement (PPA) of 89% and a negative percent agreement (NPA) of 84%. The algorithm’s performance for asthma exacerbations diagnosis exceeded its performance as a detector of patient-reported wheeze (sensitivity, 63.7%, which in isolation was an insensitive marker of asthma exacerbations (PPA =53.8%, NPA =49%).

Writing in the Journal of Asthma, the study investigators, led by paediatrician Dr Paul Porter said the algorithm had the potential to act as a point-of-care test for asthma exacerbations without requiring clinical examination or lung function testing.

“This method could improve the accuracy of telehealth consultations and might be helpful in Asthma Action Plans and patient-initiated therapy,” they wrote.

The study was supported by ResApp Health Limited.

Shingrix now available for over 18s

The non-live recombinant Varicella Zoster Virus vaccine Shingrix is now available on the private market for the prevention of shingles (herpes zoster) and post-herpetic neuralgia (PHN) in people aged 18 years who are at increased risk of shingles.

In June 2021 Shingrix was made available to people over the age of 50. According to GSK, the new approval of Shingrix was supported by a range of clinical trials in highly immunocompromised populations aged 18 years and older, including patients with solid tumours, haematological malignancies, HIV infection, autologous hematopoietic stem cell transplant recipients, and renal transplant patients on chronic immunosuppressive treatment.

The TGA has previously warned of the risks of live zoster vaccines in immunocompromised people after receiving reports of two deaths. Shingrix is given intramuscularly in two doses, six months apart.

Chronic cough risk is higher in obese individuals.

Danish research, comprising 44,554 adults from the Copenhagen General Population Study, found a dose–response relationship between BMI and chronic cough.

Compared with individuals with normal weight, multivariable adjusted ORs for chronic cough risk were 1.4 (95% CI 1.2 to 1.6) in overweight, 1.9 (95% CI 1.7 to 2.2) in obese and 2.6 (95% CI 2.1 to 3.2) in severely obese individuals.

The association was mediated by gastro-oesophageal reflux disease, low vegetable intake and occupational exposures – “supporting that there may be benefit to gain by ameliorating some of these factors in obese individuals with chronic cough”.

Read more in Thorax.