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Respiration. 2012;84(3):193-9. doi: 10.1159/000336549. Epub 2012 Mar 22.

Health status assessment in routine clinical practice: the chronic obstructive pulmonary disease assessment test score in outpatients.

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1
NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK.

Abstract

BACKGROUND:

The chronic obstructive pulmonary disease (COPD) assessment test (CAT) is a simple, self-completion questionnaire developed to measure health status in patients with COPD, which is potentially suitable for routine clinical use.

OBJECTIVES:

The purpose of this study was to establish the determinants of the CAT score in routine clinical practice.

METHODS:

Patients attending the clinic completed the CAT score before being seen. Clinical data, including, where available, plethysmographic lung volumes, transfer factor and arterial blood gas analysis, were recorded on a pro forma in the clinic.

RESULTS:

In 224 patients (36% female), mean forced expiratory volume in 1 s (FEV₁) was 40.1% (17.9) of predicted (%pred); CAT score was associated with exacerbation frequency [0-1/year 20.1 (7.6); 2-4/year 23.5 (7.8); >4/year 28.5 (7.3), p < 0.0001; 41/40/19% in each category] and with Medical Research Council (MRC) dyspnoea score (r² = 0.26, p < 0.0001) rising approximately 4 points with each grade. FEV(1) %pred had only a weak influence. Using stepwise regression, CAT score = 2.48 + 4.12 [MRC (1-5) dyspnoea score] + 0.08 (FEV(1) %pred) + 1.06 (exacerbation rate/year)] (r² = 0.36, p < 0.0001). The CAT score was higher in patients (n = 54) with daily sputum production [25.9 (7.5) vs. 22.2 (8.2); p = 0.004]. Detailed lung function (plethysmography and gas transfer) was available in 151 patients but had little influence on the CAT score.

CONCLUSION:

The CAT score is associated with clinically important variables in patients with COPD and enables health status measurement to be performed in routine clinical practice.

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PMID:
22441322
DOI:
10.1159/000336549
[Indexed for MEDLINE]
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