First validated children’s acute cough-specific quality of life questionnaire (PAC-QoL)


Published Online: October 30, 2014

The burden to families of acute cough in children is demonstrated by frequent medical presentations and the high use of over the counter medications. Measuring quality of life is important for understanding the burden of illness and for evaluating interventions in clinical research relating to acute cough in children. Now, in a study recently published in The Journal of Allergy and Clinical Immunology, S. Anderson-James and colleagues present the first validated children’s acute cough-specific quality of life questionnaire for parents and caregivers of children with acute cough.

As the initial step for the development of this questionnaire, the authors of this study conducted focus groups to obtain appropriate items that were parent-derived. A 48-item questionnaire was developed, and later reduced to 16 items using the clinical impact method, selecting items of greatest relevance to parents. Parents of 155 children (median age 2.3 years) with acute cough (<2 weeks duration) were enrolled for the validation phase. Parents completed 2 validated cough score measures, the preliminary 48-item PAC-QoL questionnaire and 3 additional questionnaires (state trait anxiety inventory, 24-hour recall short form health survey and depression, anxiety, stress scale). All measures were completed at enrolment, Day 3 and Day 14.

The authors then examined the properties of the 16-item questionnaire by comparing responses with the previously validated cough scores and other generic measures across 3 time points. The items for the PAC-QoL questionnaire had excellent internal consistency. PAC-QoL scores significantly correlated to subjective cough scores and generic measures, and were reproducible and sensitive to change over time (p<0.001). The findings of this study endorse the 16-item PAC-QoL questionnaire as a valid and reliable measure specific to children’s acute cough.

The clinical usefulness of the PAC-QoL instrument is evident as a valid and reliable patient relevant outcome measure for evaluating interventions in much needed clinical research in children with acute cough. This questionnaire assesses QoL related to childhood acute cough at a given time point and reflects changes in acute cough-specific QoL over time. Further research to confirm its reliability with a second dataset and specific relationship to an objective cough measure would strengthen the validity of this clinical research tool.


The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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