Development of claims and EHR-based algorithm for refractory chronic cough: CLeaR-CC

<bold>Introduction:</bold> A new ICD-10 code (R05.3) was implemented for chronic cough (CC), however, this is not specific to refractory CC (RCC). Currently, there is no validated method for identifying patients with RCC using electronic records. <bold>Aim:</bold> As new medications are introduced, an algorithm to identify those with RCC will be beneficial to characterize this population in real-world (RW) settings. <bold>Methods:</bold> A targeted literature review (TLR), enhanced with semi-structured interviews with 5 international cough experts from US, UK, Canada, and Korea were used to develop the algorithm. The TLR assessed disease algorithms for CC and analogues (fibromyalgia, cluster headache, migraine, muscular dystrophy) selected due to similarities in prevalence and complex diagnoses. <bold>Results:</bold> Overall, 33 articles primarily from the US and Europe were used to develop the draft algorithm. The algorithm was further refined using output from the interviews. The revised algorithm included 2 distinct clinical pathways for RCC identification: assessment over a 2-yr period, and 3 cough events within primary care over 180 days and/or a specialist visit for RCC each year (<bold>Figure</bold>). Scenario analyses will include reducing the time periods and previously excluded comorbidities. <bold>Conclusions:</bold> The CLeaR-CC algorithm (3 cough events over 180 days and/or a specialist event for 2 consecutive yrs) will optimize the identification of patients with RCC using RW data. <fig><object-id>erj;64/suppl_68/PA2138/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>