A NEWLY developed diagnostic tool is set to transform the identification of cough variant asthma (CVA), a condition where chronic cough is the primary symptom. With traditional bronchial provocation tests often inaccessible in clinical settings, this predictive nomogram offers a practical alternative to assist clinicians.
The study, conducted between 2018–2021, reviewed data from 241 patients experiencing chronic cough lasting at least 8 weeks. Of these patients, 156 (64.7%) were diagnosed with CVA. Researchers employed univariate and multivariate logistic regression analyses to pinpoint key predictors of CVA and incorporate them into the nomogram. Among the significant predictors were cough triggered by cold air, exposure to pungent odors, distinctive patterns of cough phasing, a history of allergic rhinitis, and lower percentages of the predicted value of maximum mid-expiratory flow.
The nomogram demonstrated remarkable diagnostic accuracy, achieving an area under the curve of 0.829 and a C-index of 0.920 after validation through Bootstrap resampling. At the optimal cutoff, it achieved a sensitivity of 75.3% and a specificity of 77.6%. These metrics indicate the tool’s strong potential to differentiate between CVA and other causes of chronic cough.
Decision curve analysis further highlighted the nomogram’s clinical utility, showing that it could guide more informed and effective decision-making in diagnosing CVA. This is particularly valuable for patients who cannot undergo bronchial provocation tests due to contraindications or limited resources.
The authors concluded that this new nomogram simplifies the CVA diagnostic process, offering clinicians a reliable and user-friendly tool to identify CVA, even in challenging cases. The model could help prevent misdiagnosis, leading to more targeted treatment and improved patient outcomes.
Ada Enesco, EMJ
Reference
Min J et al. Development and validation of a nomogram for predicting cough variant asthma diagnosis. BMC Pulm Med. 2025; DOI:10.1186/s12890-025-03478-3.
