SESSION TITLE: COPD Severity Metrics
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Sunday, October 27, 2013 at 03:00 PM - 04:00 PM
PURPOSE: Both the BODE index and the COPD Assessment Test (CAT), incorporating items which are strongly related to exercise capacity, provide reliable measurements of health status in COPD patients also capturing the beneficial effects induced by pulmonary rehabilitation. The aim of this study is to evaluate the validity and reliability of BODE modified by replacing the 6-min walk test (6MWT) with CAT (BOD-CAT), and the sensitivity and responsiveness of the modified index to pulmonary rehabilitation.
METHODS: Ninety-two patients with mild to severe COPD (53M and 39F; age 45-83 years) were studied. FEV1, BMI, MMRC scale, 6MWT and CAT were evaluated. Two BODE index scores were then completed: one with 6MWT and one with CAT score. In addition, 36 patients were evaluated after a six weeks pulmonary rehabilitation program.
RESULTS: Pearson correlation between 6MWT and CAT score was significant (r=-0.28; p<0.05) just as BODE and BOD-CAT (r=0,88; p<0.001). The BOD-CAT distribution overestimated the BODE by 1.5 points. The analysis of covariance of BOD-CAT score related to GOLD stages showed a significant difference (p<0.001). FEV1, 6MWT, MMRC, BODE, CAT and BOD-CAT before and after pulmonary rehabilitation were also significantly different. The size of mean change for BODE, CAT and BOD-CAT scores achieved the minimally clinically important difference only in severe COPD patients. No significant difference between the distributions of changes of BODE and BOD-CAT scores before and after rehabilitation was found.
CONCLUSIONS: The excellent correlation between the original BODE, the CAT and the BOD-CAT enables us to conclude: the CAT is a valid substitute of 6MWT; the BOD-CAT is as effective as the BODE, and it can be used as a reliable, and discriminative measurement of health status in COPD patients.
CLINICAL IMPLICATIONS: The BOD-CAT is easy to use in routine clinical practice, and is responsive to change in health status after pulmonary rehabilitation.
DISCLOSURE: The following authors have nothing to disclose: Francesca Gibellino, Laura Mammana, Nicola Ciancio, Giuseppe Di Maria
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