S76 The COPD assessment test score (CAT): a multicentre, prospective study of response to pulmonary rehabilitation. (16th November 2010)

• Record Type: Journal Article
• Authors: Dodd, J W; Hogg, L; Nolan, J; Jefford, H; Lord, V M; Garrod, R; Polkey, M I; Jones, P W; D-C Man, W; Hopkinson, N S
• Is Part Of: Thorax. Volume 65(2010)Supplement 4
• Page Start: A36
• Page End: A36
• Publication Date: 2010-11-16
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thx.2010.150938.27
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: The COPD assessment test (CAT) was introduced last year.1 It is a questionnaire that contains eight questions covering domains relating to the impact of COPD symptoms. It is a self completion questionnaire and does not require scoring software. Scores of 0–10, 11–20, 21–30, 31–40 represent mild, moderate, severe or very severe clinical impact. In cross-sectional studies it has similar scaling properties to the SGRQ, so that 1 point in the CAT is equivalent to approximately 2.5 points on the SGRQ. It is not known how the CAT score performs in the context of pulmonary rehabilitation (PR). Methods: We prospectively studied the introduction of the CAT score as an assessment tool in several pulmonary rehabilitation programs across London, where it was used alongside a range of other outcome measures in different programs including the SGRQ, CCQ, HAD score, MRC dyspnoea score and several different walking tests. Primary outcome was a comparison of change in CAT score against an anchor question used to assess overall response, scored 1 "I feel much better" 2 "I feel a little better", 3 "I feel no different", 4 "I feel a little worse", 5 "I feel much worse". Results: Data were available for 172 COPD patients, mean(SD) age 69.6(9.3) years, FEV1 51.9(18.9)% predicted, MRC dyspnoea score 3.0(0.9), CAT score 20.0(7.5) who attended five different programs. Mean improvement in CAT score after PR was 2.8(5.8) points. In those scoring "much better" (n=108) CAT fell by 3.7(6.1) points and by 1.2(4.8) in those who felt "a little better" (n=56) (p=0.01). In those scoring 3 or 4 on the anchor question (grouped together as n=8) change in CAT was −0.6(3.5). Conclusion: The CAT score improves in response to pulmonary rehabilitation and more so in those who report a greater overall improvement. Further accrual is underway to allow comparison of changes in CAT to other outcome measures.