Take the Test: How Well Controlled Is Your COPD?

Senior woman at doctor's office.
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There are several questionnaires that assess symptoms in COPD. These questionnaires have become even more important since 2011, when the Global Initiative for Chronic Obstructive Lung Disease (GOLD) committee released a recommendation that COPD be treated based on not only the results of breathing tests like spirometry but also based on how the disease impacts patients and risk of future COPD-related problems, such as exacerbations.

In fact, there are 13 different questionnaires, many of which are very complicated and have various different score systems and varied use in different contexts.

In response to this, a short, 8-item questionnaire, called the COPD Assessment Test (CAT) was created to simplify matters and to serve as a tool for practicing clinicians. While it does not diagnose COPD, it can help to assess patients who are known to have COPD.  

The CAT asks questions about symptoms like cough, mucus, and chest tightness and about physical limitations. It is available in many languages. After answering the questions, patients are given a score from 0-40, with higher scores representing worse disease control. GOLD Guidelines recommend that patients receive daily treatment when scores are 10 or higher. 

When a patient’s score changes by a magnitude of 2, it is thought to represent a significant change in symptom control.

For example, if a patient has a score of 11 and 6 months later the score is 9, this represents a significant improvement in COPD control. Or, if a patient's score was 20 and decreased to 15, this might suggest that the treatment plan is working well.

Although not all clinicians have adapted the use of this questionnaire in daily practice, it has become more widely used in both practice and research studies.

  Some research studies suggest that the CAT may be helpful in helping clinicians to become more aware of patients who are at risk for exacerbations, depression, acute deterioration in health and even risk of death. 

If you're a clinician, you can find more information and answers to frequently asked questions about the CAT in their user guide.

Other Key Facts About the CAT

  1. The CAT was developed by clinicians from multiple subspecialties as well as patient representatives. The development was funded by a pharmaceutical company (GlaxoSmithKline).
  2. The CAT has been successfully used in patients with all stages of COPD.
  3. It is recommended that patients complete the CAT every 2-3 months to follow the progression in symptoms over time.
  4. The CAT should be used in its entirety (individual questions are not scientifically validated to offer the same results). 

The Bottom Line

  • The CAT is a fast and easy questionnaire to help monitor the change in COPD symptoms over time.
  • The CAT is NOT intended to be used to diagnose COPD.
  • Clinicians may use the CAT to help decide when patients need daily treatment for their COPD.
  • The CAT can be used to assess change in symptoms over time.
  • Increases or decreases in a CAT score of 2 or more suggest a change in the control of COPD (ie. worsening or improving symptoms).


Karloh M, Mayer AF, Maurici R, Pizzichini MM, Jones PW, 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.

Global Initiative for Chronic Obstructive Lung Disease 

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