{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:07:49Z","timestamp":1789186069415,"version":"build-2803163510"},"reference-count":90,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The larynx is central to voice, breathing, swallowing, and cough\u2014such that routinely tracking related outcomes can introduce burden. Within these assessments, the Cough Severity Index (CSI) is frequently deployed. We thus utilized item response theory (IRT) to determine: (1) which items confer the most information, (2) if proposed 5\u2010item scales yield substantially differing discrimination and location parameters, compared to the 10\u2010item instrument, and (3) whether a subset of items has more favorable characteristics as an initial assessment (i.e., for whether all 10 items are needed).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Item discrimination, location, and information parameters were calculated from 4240 consecutive CSI responses. Based on these data, 5\u2010item subsets were proposed, evaluated, and compared with each other and the 10\u2010item instrument via information function curves and receiver\u2010operator characteristic (ROC) analyses. Performance of 5\u2010item mean scores &lt;\u20091 as a potential initial assessment for the full results was also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Discrimination parameters ranged from 0.65\u20132.76, with the greatest discrimination in items about embarrassment or avoiding places due to cough. These data, along with residual item correlations and location parameters, delineated a 5\u2010item subset, which also incorporated cough when lying down, affecting voice, and upset by cough for comparative analysis. ROC\u2010AUCs revealed no difference between the 5\u2010item subset and parent 10\u2010item instrument in ability to discriminate cough\u2010specific clinical diagnoses. One 5\u2010item subset performed better as an initial assessment (mean 4.9, 95% CI 4.7\u20135.2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IRT data identified a 5\u2010item CSI subset which reflects the cough trait and provides an initial efficient assessment mechanism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70667","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T09:36:54Z","timestamp":1781257014000},"page":"4392-4400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving Measurement Efficiency of the Cough Severity Index With Item Response Theory"],"prefix":"10.1002","volume":"136","author":[{"given":"Elliana K.","family":"DeVore","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5666-2482","authenticated-orcid":false,"given":"Thomas L.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4417-7700","authenticated-orcid":false,"given":"Christopher D.","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Stanlie","sequence":"additional","affiliation":[{"name":"International Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha Luc\u00eda Guti\u00e9rrez","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Universidad El Bosque, Colombian School of Medicine  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Alkhatib","sequence":"additional","affiliation":[{"name":"Department of Surgery Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-1086","authenticated-orcid":false,"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Bellmunt","sequence":"additional","affiliation":[{"name":"Ear Nose Throat Department Hospital Universitari Mollet del Vall\u00e8s. 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