Portuguese-language version of the COPD Assessment Test: validation for use in Brazil

Abstract

OBJECTIVE: To validate a Portuguese-language version of the COPD assessment test (CAT) for use in Brazil and to assess the reproducibility of this version. METHODS: This was multicenter study involving patients with stable COPD at two teaching hospitals in the city of Fortaleza, Brazil. Two independent observers (twice in one day) administered the Portuguese-language version of the CAT to 50 patients with COPD. One of those observers again administered the scale to the same patients one week later. At baseline, the patients were submitted to pulmonary function testing and the six-minute walk test (6MWT), as well as completing the previously validated Portuguese-language versions of the Saint George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (MMRC) dyspnea scale, and hospital anxiety and depression scale (HADS). RESULTS: Inter-rater and intra-rater reliability was excellent (intraclass correlation coefficient [ICC] = 0.96; 95% CI: 0.93-0.97; p < 0.001; and ICC = 0.98; 95% CI: 0.96-0.98; p < 0.001, respectively). Bland Altman plots showed good test-retest reliability. The CAT total score correlated significantly with spirometry results, 6MWT distance, SGRQ scores, MMRC dyspnea scale scores, and HADS-depression scores. CONCLUSIONS: The Portuguese-language version of the CAT is a valid, reproducible, and reliable instrument for evaluating patients with COPD in Brazil.

The COPD assessment test: a systematic review

“…The internal consistency of the CAT was reported in eight studies, with the Cronbach's a range from 0.85-0.98 indicating a high correlation between items [5,9,10,14,15,18,19,21] (table 2). Test-retest was evaluated in five studies to measure reproducibility [5,9,10,14,30] (table 2), with the CAT administered on two different occasions (at baseline and then either 1 or 2 weeks later) for three studies [5,10,30] and on three separate occasions (at baseline, 2 weeks and then 6 weeks later) for one study [14].…”

“…Test-retest was evaluated in five studies to measure reproducibility [5,9,10,14,30] (table 2), with the CAT administered on two different occasions (at baseline and then either 1 or 2 weeks later) for three studies [5,10,30] and on three separate occasions (at baseline, 2 weeks and then 6 weeks later) for one study [14]. The ICC ranged from 0.80-0.96, demonstrating that the CAT is consistent in producing scores when administered repeatedly under stable disease condition.…”

Positive end-expiratory pressure attenuates hemodynamic effects induced by an overload of inspiratory muscles in patients with COPD

“…The modified British Medical Research Council (mMRC) dyspnea scale and the COPD assessment test (CAT) questionnaire were used to assess the shortness of breath and quality of life, respectively. Both methods were previously validated for the Brazilian population 24,25. Besides the diagnosis of COPD, the inclusion criteria were clinical stability, absence of infection or exacerbation of disease in the past 4 weeks, and absence of severe heart diseases (ventricular systolic dysfunction, previous cardiac surgery, congenital cardiac malformation, arrhythmia, moderate to severe valvar heart disease, or heart failure) or other comorbidities that could affect the study protocol.…”

Efeito agudo do indacaterol mais tiotrópio versus formoterol mais tiotrópio sobre hiperinsuflação pulmonar (Estudo EFINTH) na DPOC: protocolo de estudo para um ensaio randomizado

“…A diretriz GOLD classifica a gravidade dos pacientes com DPOC em quatro grupos (A, B, C ou D) levando em consideração três parâmetros: função pulmonar; risco de exacerbação; e sintomas, avaliado por meio do "COPD Assessment Test" (CAT, Teste de Avaliação da DPOC) ou da escala de dispnéia "modified Medical Research Council" (mMRC), onde: 21,22 -Grupo B (inclui pacientes com baixo risco e mais sintomas): com limitação do fluxo aéreo leve a moderado (VEF 1 ≥ 50% do valor previsto); < 2 exacerbações no ano anterior, não necessitando de hospitalização por exacerbação; e pontuação do questionário CAT ≥ 10 ou escala de dispnéia mMRC ≥ 2 e; Grupo D (inclui pacientes com alto risco e mais sintomas): com limitação do fluxo aéreo grave a muito grave (VEF 1 < 50% do valor previsto); ≥ 2 exacerbações no ano anterior, necessitando de pelo menos uma hospitalização por exacerbação; e pontuação do questionário CAT ≥ 10 ou escala de dispnéia mMRC ≥ 2.…”