CAT score single item analysis in patients with COPD: Results from COSYCONET

TY - JOUR

T1 - CAT score single item analysis in patients with COPD: Results from COSYCONET

AU - Marietta von Siemens, Sarah

AU - Alter, Peter

AU - Lutter, Johanna I

AU - Kauczor, Hans-Ulrich

AU - Jobst, Bertram

AU - Bals, Robert

AU - Trudzinski, Franziska C

AU - Söhler, Sandra

AU - Behr, Jürgen

AU - Watz, Henrik

AU - Waschki, Benjamin

AU - Bewig, Burkhard

AU - Jones, Paul W

AU - Welte, Tobias

AU - Vogelmeier, Claus F

AU - Jörres, Rudolf A

AU - Kahnert, Kathrin

AU - COSYCONET study group

N1 - Copyright © 2019. Published by Elsevier Ltd.

PY - 2019/11

Y1 - 2019/11

N2 - The COPD Assessment Test (CAT) is in widespread use for the evaluation of patients with chronic obstructive pulmonary disease (COPD). We assessed whether the CAT items carry additional information beyond the sum score regarding COPD characteristics including emphysema. Patients of GOLD grades 1 to 4 from the COPD cohort COSYCONET (German COPD and Systemic Consequences - Comorbidities Network) with complete CAT data were included (n = 2270), of whom 493 had chest CT evaluated for the presence of emphysema. Comorbidities and lung function were assessed following standardised procedures. Cross-sectional data analysis was based on multiple regression analysis of the single CAT items against a panel of comorbidities, lung function, or CT characteristics (qualitative score, 15th percentile of mean lung density), with age, BMI and gender as covariates. This was supported by exploratory factor analysis. Regarding the relationship to comorbidities and emphysema, there were marked differences between CAT items, especially items 1 and 2 versus 3 to 8. This grouping was basically confirmed by factor analysis. Items 4 and 5, and to a lower degree 1, 2 and 6, appeared to be informative regarding the presence of emphysema, whereas the total score was not or less informative. Regarding comorbidities, similar findings as for the total CAT score were obtained for the modified Medical Research Council scale (mMRC) which was also informative regarding emphysema. Our findings suggest that the usefulness of the CAT can be increased if evaluated on the basis of single items which may be indicating the presence of comorbidities and emphysema.

AB - The COPD Assessment Test (CAT) is in widespread use for the evaluation of patients with chronic obstructive pulmonary disease (COPD). We assessed whether the CAT items carry additional information beyond the sum score regarding COPD characteristics including emphysema. Patients of GOLD grades 1 to 4 from the COPD cohort COSYCONET (German COPD and Systemic Consequences - Comorbidities Network) with complete CAT data were included (n = 2270), of whom 493 had chest CT evaluated for the presence of emphysema. Comorbidities and lung function were assessed following standardised procedures. Cross-sectional data analysis was based on multiple regression analysis of the single CAT items against a panel of comorbidities, lung function, or CT characteristics (qualitative score, 15th percentile of mean lung density), with age, BMI and gender as covariates. This was supported by exploratory factor analysis. Regarding the relationship to comorbidities and emphysema, there were marked differences between CAT items, especially items 1 and 2 versus 3 to 8. This grouping was basically confirmed by factor analysis. Items 4 and 5, and to a lower degree 1, 2 and 6, appeared to be informative regarding the presence of emphysema, whereas the total score was not or less informative. Regarding comorbidities, similar findings as for the total CAT score were obtained for the modified Medical Research Council scale (mMRC) which was also informative regarding emphysema. Our findings suggest that the usefulness of the CAT can be increased if evaluated on the basis of single items which may be indicating the presence of comorbidities and emphysema.

KW - Diagnostic Techniques, Respiratory System

KW - Pulmonary Disease, Chronic Obstructive/diagnosis

U2 - 10.1016/j.rmed.2019.105810

DO - 10.1016/j.rmed.2019.105810

M3 - SCORING: Journal article

C2 - 31739262

VL - 159

SP - 105810

JO - RESP MED

JF - RESP MED

SN - 0954-6111

ER -