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Original Research: COPD |

The COPD Assessment Test: Can It Discriminate Across COPD Subpopulations?

Nisha Gupta, MSc; Lancelot Pinto, MD; Andrea Benedetti, PhD; Pei Zhi Li, MSc; Wan C. Tan, MD; Shawn D. Aaron, MD; Kenneth R. Chapman, MD; J. Mark FitzGerald, MD; Paul Hernandez, MD; Darcy D. Marciniuk, MD; François Maltais, MD; Denis E. O'Donnell, MD; Don Sin, MD; Brandie L. Walker, MD; Jean Bourbeau, MD
Author and Funding Information

FUNDING/SUPPORT: The Canadian Cohort Obstructive Lung Disease (CanCOLD) study is currently funded by the Canadian Respiratory Research Network; industry partners are AstraZeneca Canada Ltd., Boehringer Ingelheim Canada Ltd., GlaxoSmithKline Canada Ltd., and Novartis. Researchers at RI-MUHC Montreal and Icapture Centre Vancouver lead the project. Previous funding partners were the CIHR (CIHR/Rx&D Collaborative Research Program Operating Grants, 93326) and the Respiratory Health Network of the FRSQ; industry partners were Almirall, Merck, Nycomed, Pfizer Canada Ltd., and Theratechnologies.

aRespiratory Epidemiology and Clinical Research Unit, Research Institute of McGill University Health Centre and McGill University, Montreal, QC, Canada

bUniversity of British Columbia, Vancouver, BC, Canada

cOttawa University, Ottawa, ON, Canada

dUniversity of Toronto, Toronto, ON, Canada

eDalhousie University, Halifax, NS, Canada

fUniversity of Saskatchewan, Saskatoon, SK, Canada

gInstitut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada

hQueens University, Kingston, ON, Canada

iUniversity of Calgary, Calgary, AB, Canada

CORRESPONDENCE TO: Jean Bourbeau, MD, MSc, FRCPC, Center for Innovative Medicine, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Room C047371.5, Montreal, QC, Canada H4A 3J1


Copyright 2016, . All Rights Reserved.


Chest. 2016;150(5):1069-1079. doi:10.1016/j.chest.2016.06.016
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Background  The COPD Assessment Test (CAT) is a valid disease-specific questionnaire measuring health status. However, knowledge concerning its use regarding patient and disease characteristics remains limited. Our main objective was to assess the degree to which the CAT score varies and can discriminate between specific patient population groups.

Methods  The Canadian Cohort Obstructive Lung Disease (CanCOLD) is a random-sampled, population-based, multicenter, prospective cohort that includes subjects with COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] classifications 1 to 3). The CAT questionnaire was administered at three visits (baseline, 1.5 years, and 3 years). The CAT total score was determined for sex, age groups, smoking status, GOLD classification, exacerbations, and comorbidities.

Results  A total of 716 subjects with COPD were included in the analysis. The majority of subjects (72.5%) were not previously diagnosed with COPD. The mean FEV1/FVC ratio was 61.1 ± 8.1%, with a mean FEV1 % predicted of 82.3 ± 19.3%. The mean CAT scores were 5.8 ± 5.0, 9.6 ± 6.7, and 16.1 ± 10.0 for GOLD 1, 2, and 3+ classifications, respectively. Higher CAT scores were observed in women, current smokers, ever-smokers, and subjects with a previous diagnosis of COPD. The CAT was also able to distinguish between subjects who experience exacerbations vs those who had no exacerbation.

Conclusions  These results suggest that the CAT, originally designed for use in clinically symptomatic patients with COPD, can also be used in individuals with mild airflow obstruction and newly diagnosed COPD. In addition, the CAT was able to discriminate between sexes and subjects who experience frequent and infrequent exacerbations.

Trial Registry  ClinicalTrials.gov; No.: NCT00920348; Study ID No.: IRO-93326.


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