St George's University of London, UK.
Eur Respir J. 2009 Sep;34(3):648-54. doi: 10.1183/09031936.00102509.
There is need for a validated short, simple instrument to quantify chronic obstructive pulmonary disease (COPD) impact in routine practice to aid health status assessment and communication between patient and physician. Current health-related quality of life questionnaires provide valid assessment of COPD, but are complex, which limits routine use. The aim of the present study was to develop a short validated patient-completed questionnaire, the COPD Assessment Test (CAT), assessing the impact of COPD on health status. 21 candidate items identified through qualitative research with COPD patients were used in three prospective international studies (Europe and the USA, n = 1,503). Psychometric and Rasch analyses identified eight items fitting a unidimensional model to form the CAT. Items were tested for differential functioning between countries. Internal consistency was excellent: Cronbach's alpha = 0.88. Test re-test in stable patients (n = 53) was very good (intra-class correlation coefficient 0.8). In the sample from the USA, the correlation with the COPD-specific version of the St George's Respiratory Questionnaire was r = 0.80. The difference between stable (n = 229) and exacerbation patients (n = 67) was five units of the 40-point scale (12%; p<0.0001). The CAT is a short, simple questionnaire for assessing and monitoring COPD. It has good measurement properties, is sensitive to differences in state and should provide a valid, reliable and standardised measure of COPD health status with worldwide relevance.
需要一种经过验证的简短、简单的工具来量化慢性阻塞性肺疾病（COPD）在常规实践中的影响，以帮助评估健康状况并促进医患之间的沟通。目前的健康相关生活质量问卷可对 COPD 进行有效评估，但较为复杂，限制了其常规使用。本研究旨在开发一种经过验证的简短、患者自评的问卷，即 COPD 评估测试（CAT），以评估 COPD 对健康状况的影响。通过与 COPD 患者进行定性研究确定了 21 项候选条目，这些条目被用于三项前瞻性国际研究（欧洲和美国，n=1503）。心理测量学和 Rasch 分析确定了 8 项符合单维模型的条目，形成了 CAT。对这些条目进行了国家间差异性作用的测试。内部一致性极好：Cronbach's alpha = 0.88。对稳定患者（n=53）进行的测试重测非常好（组内相关系数 0.8）。在美国的样本中，与 COPD 特异性圣乔治呼吸问卷的相关性为 r = 0.80。稳定患者（n=229）和恶化患者（n=67）之间的差异为 40 分制的 5 个单位（12%；p<0.0001）。CAT 是一种用于评估和监测 COPD 的简短、简单的问卷。它具有良好的测量特性，对状态差异敏感，应该为 COPD 健康状况提供具有全球相关性的有效、可靠和标准化的衡量标准。
