COPD 评估测试在急性加重和肺康复后的反应性测试。

Tests of the responsiveness of the COPD assessment test following acute exacerbation and pulmonary rehabilitation.

机构信息

Division of Clinical Science, St. George's University of London, London, England.

Center for Health Outcomes Research, United Biosource Corporation, Bethesda, MD.

出版信息

Chest. 2012 Jul;142(1):134-140. doi: 10.1378/chest.11-0309.

DOI:10.1378/chest.11-0309

PMID:22281796

Abstract

BACKGROUND

The COPD Assessment Test (CAT) is an eight-item questionnaire suitable for routine clinical use that shows reliability and validity in stable and exacerbating COPD.

METHODS

Study 1 assessed CAT responsiveness to changes in health status in 67 patients during an exacerbation (days 1-14). Study 2 assessed CAT responsiveness in 64 patients undergoing pulmonary rehabilitation (days 1-42). Correlations between CAT and other outcome measures were examined.

RESULTS

In study 1, mean 14-day improvement in CAT score was -1.4 ± 5.3 units (P = .03). In patients judged to be responders (clinician defined) change in score was -2.6 ± 4.4; in nonresponders it was -0.2 ± 5.9. In study 2, the mean improvement in CAT score was -2.2 ± 5.3 (P = .002); the effect size for the change was -0.33. Effect size for changes in the Chronic Respiratory Questionnaire-Self Administered Standardized (CRQ-SAS) form domain scores ranged from -0.02 to 0.34. Change in 6-min walk distance (6MWD) was 41 ± 55 m. CAT and CRQ-SAS domain scores correlated at baseline (r = -0.54 to -0.69, P < .0001) and in terms of change following pulmonary rehabilitation (r = -0.39 to -0.63, P < .01). Correlations were less strong between change in the CAT and St. George Respiratory Questionnaire for COPD in study 1 (r < 0.24) and for 6MWD (r < 0.11) in study 2.

CONCLUSIONS

These studies indicate that the CAT is sensitive to changes in health status following exacerbations and is as responsive to pulmonary rehabilitation as more complex COPD health status measures.

摘要

背景

COPD 评估测试（CAT）是一种适合常规临床使用的八项问卷，在稳定期和加重期 COPD 中均具有可靠性和有效性。

方法

研究 1 在 67 例加重期患者（第 1-14 天）中评估 CAT 对健康状况变化的反应性。研究 2 在 64 例接受肺康复治疗的患者中评估 CAT 的反应性（第 1-42 天）。研究了 CAT 与其他结局测量之间的相关性。

结果

在研究 1 中，CAT 评分的 14 天平均改善为-1.4 ± 5.3 单位（P =.03）。在被判定为有反应者（临床医生定义）的患者中，评分变化为-2.6 ± 4.4；在无反应者中，评分变化为-0.2 ± 5.9。在研究 2 中，CAT 评分的平均改善为-2.2 ± 5.3（P =.002）；变化的效应大小为-0.33。慢性呼吸系统问卷-自我管理标准化（CRQ-SAS）表单域评分变化的效应大小范围为-0.02 至 0.34。6 分钟步行距离（6MWD）的变化为 41 ± 55 m。CAT 和 CRQ-SAS 域评分在基线时（r = -0.54 至-0.69，P <.0001）以及肺康复后变化时（r = -0.39 至-0.63，P <.01）均相关。在研究 1 中，CAT 与圣乔治呼吸问卷的变化之间的相关性较弱（r < 0.24），在研究 2 中，CAT 与 6MWD 的变化之间的相关性较弱（r < 0.11）。