Health Status Assessment in Routine Clinical Practice: The Chronic Obstructive Pulmonary Disease Assessment Test Score in Outpatients

Kelly, Julia L.; Bamsey, Olivia; Smith, Cayley; Lord, Victoria; Shrikrishna, Dinesh; Jones, Paul; Polkey, Michael I.; Hopkinson, Nicholas S

doi:10.1159/000336549

Cited by 91 publications

(86 citation statements)

References 56 publications

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“…[25]; and mMRC score [9,27,37]. The CAT score was not statistically different (po0.05) in the following categories: sex [11,20,21,29]; age (defined as f65 years versus .65 years) [20,29]; current smokers versus nonsmokers [23]; and comorbidities (defined as 0, 1-2 or o3 comorbidities) [20,25]. COPD: chronic obstructive pulmonary disease; ICC: intra-class correlation coefficient; NR: not reported; NA: not applicable.…”

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confidence: 91%

The COPD assessment test: a systematic review

et al. 2014

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The COPD assessment test (CAT) is a self-administered questionnaire that measures healthrelated quality of life. We aimed to systematically evaluate the literature for reliability, validity, responsiveness and minimum clinically important difference (MCID) of the CAT.Multiple databases were searched for studies analysing the psychometric properties of the CAT in adults with chronic obstructive pulmonary disease. Two reviewers independently screened, selected and extracted data, and assessed methodological quality of relevant studies using the COSMIN checklist.From 792 records identified, 36 studies were included. The number of participants ranged from 45 to 6469, mean age from 56 to 73 years, and mean forced expiratory volume in 1 s from 39% to 98% predicted. Internal consistency (reliability) was 0.85-0.98, and test-retest reliability was 0.80-0.96. Convergent and longitudinal validity using Pearson's correlation coefficient were: SGRQ-C 0.69-0.82 and 0.63, CCQ 0.68-0.78 and 0.60, and mMRC 0.29-0.61 and 0.20, respectively. Scores differed with GOLD stages, exacerbation and mMRC grades. Mean scores decreased with pulmonary rehabilitation (2.2-3 units) and increased at exacerbation onset (4.7 units). Only one study with adequate methodology reported an MCID of 2 units and 3.3-3.8 units using the anchor-based approach and distribution-based approach, respectively. Most studies had fair methodological quality.We conclude that the studies support the reliability and validity of the CAT and that the tool is responsive to interventions, although the MCID remains debatable. @ERSpublications Studies support the reliability, validity and responsiveness of the CAT as a HRQoL tool but its MCID remains unclear

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confidence: 91%

The COPD assessment test: a systematic review

et al. 2014

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“…This tool has questions on the level of dyspnea and the feeling caused by shortness of breath, the presence of cough and the characteristics of the cough and exercise tolerance. [34][35][36][37][38][39][40][41] C: St. George's Respiratory Questionnaire (SGRQ). This is the most widely used tool.…”

Section: Stagingmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease: An Overview of Epidemiology, Pathophysiology, Diagnosis, Staging and Management

Akwe

Fair²

2016

IJCEMS

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Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease. It is among the fastest growing chronic diseases diagnosed in the world today. COPD is the third most common cause of death in the United States. It is characterized by the development of an inflammatory response of the lungs to noxious substances such as tobacco or air pollution. If the exposure becomes recurrent or persistent, the lungs develop chronic inflammatory response leading to lung parenchymal damage, air trapping and progressive airflow limitation. The Diagnosis of COPD is usually made in the context of symptoms and spirometry evidence of airway obstruction with post bronchodilator spirometry FEV1/FVC < 0.70. Most patients with COPD first seek medical attention when they develop dyspnea. Once the diagnosis of COPD is confirmed, the treatment is geared mainly towards preventing exacerbations and eliminating risk factors and exposures. Several treatment combinations can be used in patients with stable COPD to prevent exacerbations and to improve their quality of life. Patients with COPD exacerbations have to be appropriately diagnosed and promptly treated to prevent complications. Patient's symptoms, the degree of airflow limitation, risk of exacerbations and the presence of comorbidities have to be assessed. Both pharmacological and non-pharmacological interventions have been used in the management of COPD. Appropriate pharmacologic therapy can reduce COPD symptoms, reduce the frequency and severity of exacerbations, and improve health status and exercise tolerance. None of the existing medications for COPD have been shown conclusively to modify the long-term decline in lung function.

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“…The current study clearly shows that this is the case in patients who were not enrolled in clinical trials and were unmotivated for reasons other than clinical ones. The study by Kelly et al [4] confirms that, despite (or because of) its simplicity, the CAT is a mine of information. In particular, a strong association was found between the CAT score and the rate of exacerbations and the degree of dyspnea perception in an unselected outpatient population.…”

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confidence: 94%

“…A new tool that is easy to complete and interpret, and therefore more readily incorporated into routine care, is strongly advocated. The study by Kelly et al [4] in this issue of Respiration has the merit of introducing and validating a new questionnaire, which specifically addresses COPD-related health conditions in daily clinical practice, thus removing the existing gap between the world of research and the field of real life.…”

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confidence: 99%