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Title: Components of the COPD assessment test (CAT) associated with a diagnosis of COPD in a random population sample
Authors: Natya Raghavan
Yuk Miu Lam
Katherine A. Webb
Jordan A. Guenette
Naparat Amornputtisathaporn
Ramya Raghavan
Wan C. Tan
Jean Bourbeau
Denis E. O'Donnell
Queen's University, Kingston
Mahidol University
Oakridges Heart Clinic
The University of British Columbia
McGill University
Keywords: Medicine
Issue Date: 1-Apr-2012
Citation: COPD: Journal of Chronic Obstructive Pulmonary Disease. Vol.9, No.2 (2012), 175-183
Abstract: The aim of this study was to determine if components of the COPD Assessment Test (CAT), a validated health status impairment instrument, had additional utility in identifying patients at risk for COPD in whom spirometry testing is appropriate. This study was part of the Canadian Obstructive Lung Disease prevalence study. Consenting participants ≥ 40 years of age were identified by random digit dialing. Smoking history, 8-item CAT scores, and post-bronchodilator spirometry were recorded for each. Stepwise logistic regression analysis was used to identify variables related to the presence of airway obstruction and a final logistic model was developed which best predicted COPD in this sample. Of the 801 individuals approached, 532 were included: 51 (9.6%) had COPD, the majority (92%) of whom fit GOLD I or II severity criteria. Items that correlated significantly with a COPD diagnosis included the CAT total score (p = 0.01) and its breathlessness (p < 0.0001) and phlegm (p = 0.001) components. The final logistic model included: age ( < 55 or ≥55 years), smoking status (current, former, never) and the CAT breathlessness score (ordinal scale 05). The area under the receiver-operating characteristic curve for this model was 0.77, sensitivity was 77.6%, specificity was 64.9% and the positive likelihood ratio was 2.21. In summary, the triad of smoking history, age at least 55 years and the presence of exertional breathlessness were key elements of a simple model which had reliable measurement properties when tested in a random population. This may help identify patients at risk for COPD for whom spirometry testing is recommended. © 2012 Informa Healthcare USA, Inc.
ISSN: 15412563
Appears in Collections:Scopus 2011-2015

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