Gibson and colleagues defined an unexplained chronic cough in adults as a cough that persists longer than 8 weeks and remains unexplained after investigation and supervised therapeutic trials done according to best-practice guidelines in an adherent patient. The authors further specified that the cough could remain unexplained because chronic cough had no diagnosable cause, a putative diagnosis was made but it was refractory to treatment, or the cause of the cough was not diagnosable and remained refractory to treatments. The authors stressed the importance of addressing two clinical needs that must be met to improve the poor quality of life of patients with unexplained chronic cough—a challenging clinical disorder that has defied either diagnosis or treatment. The first clinical need is the development of new therapies that are approved by regulatory agencies and the question of how best to study them. The second need is for clinicians to practice intervention fidelity by closely adhering to the best clinical practice guidelines for chronic cough management; clinicians and researchers should not deviate from following the best clinical practice diagnostic and treatment guidelines and researchers should carefully specify in their publications how studies ensured intervention fidelity to such guidelines. These actions are important to avoid cough due to treatable underlying causes being left undiagnosed and falsely labelled as unexplained.

中文翻译：

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处理成人无法解释的慢性咳嗽：未满足的需求是什么？

吉布森及其同事将成人无法解释的慢性咳嗽定义为持续超过8周并且在根据最佳实践指南对依从性患者进行调查和监督治疗试验后仍然无法解释的咳嗽。作者进一步指出，咳嗽可能无法解释，因为慢性咳嗽没有可诊断的原因，做出了诊断，但对治疗是难治的，或者咳嗽的原因无法诊断并且对治疗仍然是难治的。作者强调解决两个原因的重要性，以改善无法解释的慢性咳嗽患者的生活质量，这是一种具有挑战性的临床疾病，已经困扰着诊断或治疗，因此必须予以满足。第一个临床需求是开发新的疗法，该疗法已获得监管机构的批准，以及如何最好地研究它们的问题。第二个需要是临床医生通过严格遵守慢性咳嗽治疗的最佳临床实践指南来实践干预的忠诚度；临床医生和研究人员不应偏离遵循最佳临床实践的诊断和治疗指南，研究人员应在出版物中仔细说明研究如何确保干预保真度符合此类指南。这些措施对于避免因无法治疗的潜在根本原因引起的咳嗽很重要，并且错误地将其标记为无法解释。第二个需要是临床医生要严格遵守慢性咳嗽治疗的最佳临床实践指南，以实践干预的忠诚度；临床医生和研究人员不应偏离遵循最佳临床实践的诊断和治疗指南，研究人员应在出版物中仔细说明研究如何确保干预保真度符合此类指南。这些措施对于避免因无法治疗的潜在根本原因引起的咳嗽很重要，并且错误地将其标记为无法解释。第二个需要是临床医生要严格遵守慢性咳嗽治疗的最佳临床实践指南，以实践干预的忠诚度；临床医生和研究人员不应偏离遵循最佳临床实践的诊断和治疗指南，研究人员应在出版物中仔细说明研究如何确保干预保真度符合此类指南。这些措施对于避免因无法治疗的潜在根本原因引起的咳嗽很重要，并且错误地将其标记为无法解释。