Performance of the COPD Assessment Test in patients with connective tissue disease-associated interstitial lung disease

Respir Med. 2019 Apr:150:15-20. doi: 10.1016/j.rmed.2019.01.017. Epub 2019 Feb 1.

Abstract

Background: Patients with connective tissue disease-associated interstitial lung disease (CTD-ILD) often experience impaired health status. In daily clinical practice, a short and easy instrument for assessing health status would be useful to help better understand the patient's condition. The COPD Assessment Test (CAT) is a simple questionnaire about respiratory symptoms and their impact. We aimed to examine the CAT's performance characteristics and to generate data to support its reliability and validity in patients with CTD-ILD.

Methods: We used data from 132 CTD-ILD patients evaluated at Tosei General Hospital from July 2011 to July 2016 to assess the cross-sectional and longitudinal validity of the CAT.

Results: The mean age of the patients was 64.5 years and 87 (66%) were women. There were no significant differences in CAT score between any of the CTD subgroups. Internal consistency (Cronbach's α = 0.881) and repeatability (intraclass correlation coefficient [ICC] = 0.803) for the CAT score were acceptable. At baseline, CAT score was significantly associated with clinically meaningful measures of physiologic function, exercise capacity, and dyspnea. Change in CAT score over 6-12 months was also associated with change in other measures. In the distribution- and anchor-based analyses, the estimated minimal clinically important difference of CAT score was 1-4 points.

Conclusion: These data support the validity and reliability of CAT as a sensitive measure for assessing health status in patients with CTD-ILD.

Keywords: CAT; COPD Assessment Test; CTD-ILD; Connective tissue disease-associated interstitial lung disease; Health status; Quality of life.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Gas Analysis / methods
  • Connective Tissue Diseases / complications*
  • Connective Tissue Diseases / diagnosis
  • Connective Tissue Diseases / physiopathology
  • Cross-Sectional Studies
  • Dyspnea / diagnosis*
  • Dyspnea / physiopathology
  • Dyspnea / psychology
  • Exercise
  • Female
  • Health Status
  • Humans
  • Lung Diseases, Interstitial / complications*
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / physiopathology
  • Male
  • Middle Aged
  • Physical Endurance / physiology
  • Pulmonary Disease, Chronic Obstructive / blood
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Quality of Life
  • Reproducibility of Results
  • Respiratory Function Tests / methods
  • Retrospective Studies
  • Surveys and Questionnaires / standards*
  • Surveys and Questionnaires / statistics & numerical data