• Nisha Gupta, Lancelot Pinto, Andrea Benedetti, Pei Zhi Li, Wan C Tan, Shawn D Aaron, Kenneth R Chapman, J Mark FitzGerald, Paul Hernandez, Darcy D Marciniuk, François Maltais, Denis E O'Donnell, Don Sin, Brandie L Walker, Jean Bourbeau, and Canadian Respiratory Research Network and the CanCOLD Collaborative Research Group.
• Respiratory Epidemiology and Clinical Research Unit, Research Institute of McGill University Health Centre and McGill University, Montreal, QC, Canada.
• Chest. 2016 Nov 1; 150 (5): 1069-1079.

BackgroundThe 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.MethodsThe 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.ResultsA 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.ConclusionsThese 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 RegistryClinicalTrials.gov; No.: NCT00920348; Study ID No.: IRO-93326.Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

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