Quality of life associated with chronic cough in the multinational burden of obstructive lung disease (BOLD) study: a cross-sectional study
The findings indicate the need for increased awareness about chronic cough and its association with reduced quality of life, particularly in low- and middle-income countries.BackgroundChronic cough (CC) can impact daily life and persist for years. Its prevalence varies globally, but whether quality of life in CC also varies across regions is unknown. This study investigates the association of CC with mental and physical component scores of the 12-item Short Form Health Survey (SF-12) reflecting health-related quality of life in a multinational study.MethodsWe analysed data from 19 642 adults (≥40 years), recruited between Jan 2, 2003 and Dec 26, 2016 in 31 sites (25 countries) from the Burden of Obstructive Lung Disease (BOLD) study, who provided information on quality of life and CC. We assessed associations using linear regression, adjusted for confounders, and used random-effects meta-analysis to examine differences by sex and gross national income.FindingsOverall, lower mental (−1.42, 95%CI −2.11 to −0.73; I2=32.7%) and physical (−2.59, 95%CI −3.22 to −1.96; I2=40.1%) health scores were associated with chronic cough. The association between physical health score and CC did not materially differ between sexes or gross national income. In males, physical health seems to be more affected by CC amongst those living in low- and middle-income countries (LMICs). In females, mental health also seems to be more affected by CC amongst those living in LMICs.InterpretationCC impairs health-related quality of life globally. However, it appears that physical health in males and mental health in females living in LMICs may be particularly affected by CC. These findings support the need to consider CC as a target for specific interventions to attenuate its burden on health and the economy.Funding.Wellcome Trust (085 790/Z/08/Z)
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![What can be learned when multiple analysts arrive at different estimates
Kowall et al. (2025) have brought the multi-analyst approach to epidemiology, with instructive results. With this approach, multiple researchers analyze the same data set to answer the same research question. Or, at least, what appears to be the same research question. In fact, the very first paper that popularized this approach [1] has been criticized for using a vague research question (“Are soccer referees more likely to give red cards to players with dark skin tone than light skin tone?”), which apparently led the analysts to try to answer quite different questions—from a simple question about a bivariate statistical association to much more complex causal questions about racial bias [2].
In contrast, the research question passed on to analysts in Kowall et al. (2025) seems less ambiguous: Does marital status influence the incidence of cardiovascular disease? But less ambiguous does not equal unambiguous. Considerable...](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:gz53felr7btxgmbxae5aooxi/bafkreidvs4c7wvoh63tr2ptmvnnl5hya246ofttwyzlvotkmqhnpwgbf4a)
