Is the COPD Assessment Test Sensitive for Differentiating COPD Patients from Active Smokers and Nonsmokers Without Lung Function Impairment? A Population-based Study

Overview

Journal J Bras Pneumol

Specialty Pulmonary Medicine

Date 2018 Jul 26

PMID 30043888

Citations 8

Authors

Manuela Karloh

Simone Aparecida Vieira Rocha

Marcia Margaret Menezes Pizzichini

Francine Cavalli

Darlan Lauricio Matte

Emilio Pizzichini

Affiliations

Soon will be listed here.

Abstract

Objective: To assess COPD Assessment Test (CAT) scores in adults with and without COPD, as well as to compare the CAT scores for nonsmokers, former smokers, and smokers without COPD with those for patients with COPD.

Methods: This was a cross-sectional population-based study (the Respira Floripa study). The study included adults ≥ 40 years of age residing in the city of Florianópolis, Brazil. A total of 846 households were surveyed. In addition to completing the Respira Floripa questionnaire and the CAT, participants underwent pulmonary function testing.

Results: We analyzed data on 1,057 participants (88.1% of the predicted sample size). A functional diagnosis of COPD was made in 92 participants (8.7%). Of those, 72% were unaware that they had COPD. The mean CAT score was higher in the group of COPD patients than in that of individuals without COPD (10.6 [95% CI: 8.8-12.4] vs. 6.6 [95% CI: 6.1-7.0]; p < 0.01). Individual item scores were significantly higher in the patients with COPD than in the individuals without COPD (p < 0.001), the exception being the scores for the items related to sleep (p = 0.13) and energy (p = 0.08). The mean CAT score was higher in the group of COPD patients than in nonsmokers (5.8 [95% CI: 5.3-6.4]) and former smokers (6.4 [95% CI: 5.6-7.2]; p < 0.05). However, there were no significant differences in the mean CAT score between the group of COPD patients and smokers without COPD (9.5 [95% CI: 8.2-10.8]; p > 0.05), the exception being the mean scores for confidence leaving home (p = 0.02).

Conclusions: CAT scores were higher in the group of patients with COPD than in nonsmokers and former smokers without COPD. However, there were no significant differences in CAT scores between COPD patients and smokers without COPD. Smokers with an FEV1/FVC ratio > 0.70 have impaired health status and respiratory symptoms similar to those observed in COPD patients.

Citing Articles

Minimally Important Difference of the 20-m 6-Minute Walk Test in Individuals With COPD.

Klein S, Munari A, Karloh M, Mucha F, Silva I, Mayer A Respir Care. 2023; 68(11):1546-1552.

PMID: 37311628 PMC: 10589114. DOI: 10.4187/respcare.10917.

Validity, Reproducibility, and Minimal Detectable Difference of the Functional Upper Extremity Function Test - Simplified Version - for Adults With Moderate to Severe Asthma and COPD.

Correia N, Oliveira J, Fernandes D, Feitosa D, Pereira D, do Amaral D Respir Care. 2023; 68(8):1058-1066.

PMID: 37221086 PMC: 10353162. DOI: 10.4187/respcare.10464.

Prevalence and incidence of chronic obstructive pulmonary disease in Latin America and the Caribbean: a systematic review and meta-analysis.

Olortegui-Rodriguez J, Soriano-Moreno D, Benites-Bullon A, Pelayo-Luis P, Huaringa-Marcelo J BMC Pulm Med. 2022; 22(1):273.

PMID: 35842603 PMC: 9288210. DOI: 10.1186/s12890-022-02067-y.

Higher COPD Assessment Test Score Associated With Greater Exacerbations Risk: A Post Hoc Analysis of the IMPACT Trial.

Thomashow B, Stiegler M, Criner G, Dransfield M, Halpin D, Han M Chronic Obstr Pulm Dis. 2021; 9(1):68-79.

PMID: 34972260 PMC: 8893967. DOI: 10.15326/jcopdf.2021.0259.

The COPD (Chronic Obstructive Pulmonary Disease) Assessment Test: Assessment of Therapeutic Outcomes of Patients at Private Hospitals in Yogyakarta.

Sari C, Hanifah S, Rosdiana R, Anisa Y J Pharm Bioallied Sci. 2021; 12(Suppl 2):S821-S825.

PMID: 33828383 PMC: 8021055. DOI: 10.4103/jpbs.JPBS_302_19.

References

Kon S, Canavan J, Jones S, M Nolan C, Clark A, Dickson M . Minimum clinically important difference for the COPD Assessment Test: a prospective analysis. Lancet Respir Med. 2014; 2(3):195-203. DOI: 10.1016/S2213-2600(14)70001-3. View

Spencer S, Calverley P, Burge P, Jones P . Health status deterioration in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001; 163(1):122-8. DOI: 10.1164/ajrccm.163.1.2005009. View

Jones P, Brusselle G, Dal Negro R, Ferrer M, Kardos P, Levy M . Properties of the COPD assessment test in a cross-sectional European study. Eur Respir J. 2011; 38(1):29-35. DOI: 10.1183/09031936.00177210. View

Nishimura K, Mitsuma S, Kobayashi A, Yanagida M, Nakayasu K, Hasegawa Y . COPD and disease-specific health status in a working population. Respir Res. 2013; 14:61. PMC: 3679860. DOI: 10.1186/1465-9921-14-61. View

Miyazaki M, Nakamura H, Chubachi S, Sasaki M, Haraguchi M, Yoshida S . Analysis of comorbid factors that increase the COPD assessment test scores. Respir Res. 2014; 15:13. PMC: 3922022. DOI: 10.1186/1465-9921-15-13. View

Regan E, Lynch D, Curran-Everett D, Curtis J, Austin J, Grenier P . Clinical and Radiologic Disease in Smokers With Normal Spirometry. JAMA Intern Med. 2015; 175(9):1539-49. PMC: 4564354. DOI: 10.1001/jamainternmed.2015.2735. View

Hankinson J, Odencrantz J, Fedan K . Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999; 159(1):179-87. DOI: 10.1164/ajrccm.159.1.9712108. View

Jones P, Harding G, Berry P, Wiklund I, Chen W, Leidy N . Development and first validation of the COPD Assessment Test. Eur Respir J. 2009; 34(3):648-54. DOI: 10.1183/09031936.00102509. View

Botega N, Bio M, Zomignani M, Garcia Jr C, Pereira W . [Mood disorders among inpatients in ambulatory and validation of the anxiety and depression scale HAD]. Rev Saude Publica. 1995; 29(5):355-63. DOI: 10.1590/s0034-89101995000500004. View

10.

Ferris B . Epidemiology Standardization Project (American Thoracic Society). Am Rev Respir Dis. 1978; 118(6 Pt 2):1-120. View

11.

Caminha G, Melo Junior J, Hopkins C, Pizzichini E, Pizzichini M . SNOT-22: psychometric properties and cross-cultural adaptation into the Portuguese language spoken in Brazil. Braz J Otorhinolaryngol. 2013; 78(6):34-9. PMC: 9446342. DOI: 10.5935/1808-8694.20120030. View

12.

Gao Y, Hou Q, Wang H . Assessment of health status in patients with newly diagnosed chronic obstructive pulmonary disease. PLoS One. 2013; 8(12):e82782. PMC: 3857270. DOI: 10.1371/journal.pone.0082782. View

13.

Celli B, MacNee W . Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004; 23(6):932-46. DOI: 10.1183/09031936.04.00014304. View

14.

Woodruff P, Barr R, Bleecker E, Christenson S, Couper D, Curtis J . Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function. N Engl J Med. 2016; 374(19):1811-21. PMC: 4968204. DOI: 10.1056/NEJMoa1505971. View

15.

Raghavan N, Lam Y, Webb K, Guenette J, Amornputtisathaporn N, Raghavan R . Components of the COPD Assessment Test (CAT) associated with a diagnosis of COPD in a random population sample. COPD. 2012; 9(2):175-83. DOI: 10.3109/15412555.2011.650802. View

16.

Fabbri L . Smoking, Not COPD, as the Disease. N Engl J Med. 2016; 374(19):1885-6. DOI: 10.1056/NEJMe1515508. View

17.

. The European Community Respiratory Health Survey II. Eur Respir J. 2002; 20(5):1071-9. DOI: 10.1183/09031936.02.00046802. View

18.

Bertolazi A, Fagondes S, Hoff L, Dartora E, Miozzo I, de Barba M . Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Med. 2010; 12(1):70-5. DOI: 10.1016/j.sleep.2010.04.020. View

19.

Karloh M, Mayer A, Maurici R, Pizzichini M, Jones P, Pizzichini E . The COPD Assessment Test: What Do We Know So Far?: A Systematic Review and Meta-Analysis About Clinical Outcomes Prediction and Classification of Patients Into GOLD Stages. Chest. 2015; 149(2):413-425. DOI: 10.1378/chest.15-1752. View

20.

Miller M, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A . Standardisation of spirometry. Eur Respir J. 2005; 26(2):319-38. DOI: 10.1183/09031936.05.00034805. View