Abdul Rehman, Mustansar Mahmood Waraich, Irfan Ullah.
Algorithm for the diagnosis of chronic cough in children 6 to 59-months.
Pak Paed J Jan ;33(1):30-8.

Objective: Chronic cough is a common and distressing symptom. A novel algorithm has been developed for underdeveloped countries to improve the management of chronic coughing children 6-month to 59-months of age, in which the diagnosis of different causes were based on the clinical clues as well as basic investigations like CXR, Mx test and CBC, as per required. Method: The performance of this algorithm in clinical practice was evaluated in a prospective cohort pilot study conducted at a Pediatric Clinic at Liaqatpur (Pakistan) in children aged 6-months to 59-months with cough persisting more than 4 weeks from October 2006 to February 2008. Results: Total 161 children were studied. Out of which 9 children (5.6%) were referred during initial assessment. Among the 161 children studied, CXR was performed in 75.77% cases; Mx test was performed in 72.67% cases while CBC was done in 34.16% cases. Using the algorithm, an initial clinical diagnosis was given in 152 cases while a final diagnosis was confirmed in 140 (92.1%) of patients. The positive predictive value of clinical diagnosis in this study was 0.921 Conclusion: This protocol has the potential to improve management by, reducing the number of investigations performed, and minimizing delays in treatment.

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