Take the Test: How Well Controlled Is Your COPD?

Understanding the COPD Assessment Test (CAT)

Senior woman at doctor's office.
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There are a number of different questionnaires that assess symptoms that COPD patients might be having. These questionnaires have become even more important since 2011, when the Global Initiative for 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 the risk of future COPD-related problems, such as exacerbations that could create the need for more treatment.

Many of these questionnaires are very complicated and have various scoring systems and a variety of uses in different contexts.

The COPD Assessment Test (CAT)

In response to the variety of questionnaires, a short, eight-item questionnaire, called the COPD Assessment Test (CAT) was created to simplify matters and to serve as a tool for practicing clinicians. While it doesn't diagnose COPD, it can help to assess patients who are known to have COPD. If you're a COPD patient, it can also be useful to you personally to keep track of how your COPD is progressing, how severe your symptoms are, and to keep an eye on how your treatment plan is working.

Understanding the CAT

The CAT asks questions about symptoms like cough, mucus, and chest tightness and about physical limitations and 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 their scores are 10 or higher.

When a patient’s score changes by a magnitude of 2, this shows 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 increased to 25, this suggests that the treatment plan isn't working well.

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

Here are some other interesting and noteworthy facts about the CAT:

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

Sources:

Karloh M, Mayer AF, Maurici R, Pizzichini MM, Jones PW, Pizzichini E. The COPD Assessment Test: What Do We Know so Far?. Chest Journal. February 2016;149(2):413-425. doi:10.1378/chest.15-1752.

Global Initiative for Obstructive Lung Disease (GOLD). GOLD 2017 Global Strategy for the Diagnosis, Management, and Prevention of COPD. Updated 2017.

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