Portuguese cough hypersensitivity questionnaire in chronic respiratory disease

A validated tool to assess cough hypersensitivity in European Portuguese speakers with chronic respiratory diseases (CRD) and chronic cough (CC) is currently lacking. This study aimed to translate, culturally adapt, and explore the measurement properties of the European Portuguese version of the Cough Hypersensitivity Questionnaire (CHQ-PT) in chronic cough associated with CRD. This two-phased study included: (1) translation and cultural adaptation, and (2) measurement properties evaluation. Internal consistency (Cronbach's α), test-retest reliability, inter-rater (between different assessors) reliability (intraclass correlation coefficient 95% confidence intervals-ICC 3,1 [95%CI] and ICC 2,1 [95%CI]), agreement (standard error of measurement-[ sem ], minimal detectable change 95% confidence level [MDC 95 ]), floor/ceiling effects, and construct validity (convergent/divergent – Pearson correlation coefficient[r]/Spearman's[ρ]) were evaluated. Two forward/back-translations and cognitive debriefing (n=8) were conducted. Fifty-two participants (48% women, 66±12 years, 72% interstitial lung disease) were included. Internal consistency was good for the CHQ-PT total score (α=0.80). Test-retest reliability of the total score was good (ICC 3,1 =0.85[0.76;0.91]) with acceptable measurement error ( sem =1.89; MDC 95 =5.24). Inter-rater reliability was also good (ICC=0.80 [0.66–0.89) No floor/ceiling effects were found. Construct validity was supported by moderate correlations with cough-related quality of life (ρ=-0.52), dyspnoea (ρ=0.43), and fatigue (r=-0.55). Domain-level analyses showed lower repeatability for the laryngeal sensations’ domain (ICC 3,1 =0.65[0.47;0.78]; ICC 2,1 =0.43[0.18;0.63]). The CHQ-PT is a reliable and valid instrument for assessing cough hypersensitivity in European Portuguese individuals with CRD and CC.