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Development and first validation of the COPD Assessment Test.

P W Jones1, G Harding, P Berry

  • 1St George's University of London, UK. pjones@sgul.ac.uk

The European Respiratory Journal
|September 2, 2009
PubMed
Summary
This summary is machine-generated.

A new short questionnaire, the COPD Assessment Test (CAT), effectively measures the health status impact of chronic obstructive pulmonary disease (COPD). This validated tool simplifies routine assessment and patient-physician communication for COPD management.

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Area of Science:

  • Pulmonary Medicine
  • Health Outcomes Research
  • Medical Device Development

Background:

  • Current health-related quality of life questionnaires for chronic obstructive pulmonary disease (COPD) are often too complex for routine clinical practice.
  • There is a need for a validated, brief instrument to assess COPD impact on patient health status and facilitate communication.
  • Existing tools limit the timely and efficient assessment of COPD in daily healthcare settings.

Purpose of the Study:

  • To develop and validate a short, patient-completed questionnaire to quantify the impact of COPD on health status.
  • To create a tool, the COPD Assessment Test (CAT), suitable for routine clinical use and patient-physician communication.
  • To establish a reliable and standardized measure for assessing COPD health status globally.

Main Methods:

  • Development of the COPD Assessment Test (CAT) using 21 candidate items from qualitative research with COPD patients.
  • Validation through three international prospective studies (n=1,503) involving psychometric and Rasch analyses.
  • Assessment of internal consistency (Cronbach's alpha=0.88), test-retest reliability (ICC=0.8), and correlation with existing measures (r=0.80).

Main Results:

  • The COPD Assessment Test (CAT) comprises eight items fitting a unidimensional model, demonstrating excellent internal consistency and reliability.
  • CAT showed significant sensitivity to disease state, differentiating between stable and exacerbation patients (5-unit difference, p<0.0001).
  • Strong correlation (r=0.80) with the St George's Respiratory Questionnaire indicates robust construct validity.

Conclusions:

  • The COPD Assessment Test (CAT) is a short, simple, and validated instrument for assessing and monitoring the health status impact of COPD.
  • The CAT possesses good measurement properties, is sensitive to changes in patient state, and offers worldwide relevance.
  • This questionnaire is suitable for routine practice, aiding health status assessment and improving patient-physician communication in COPD care.