评估 COPD 患者的健康状况。COPD 评估测试（CAT）和临床 COPD 问卷（CCQ）的头对头比较。
Assessing health status in COPD. A head-to-head comparison between the COPD assessment test (CAT) and the clinical COPD questionnaire (CCQ).
机构信息
Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Crete, PO 71003, Greece.
出版信息
BMC Pulm Med. 2012 May 20;12:20. doi: 10.1186/1471-2466-12-20.
BACKGROUND
Health status provides valuable information, complementary to spirometry and improvement of health status has become an important treatment goal in COPD management. We compared the usefulness and validity of the COPD Assessment Test (CAT) and the Clinical COPD Questionnaire (CCQ), two simple questionnaires, in comparison with the St. George Respiratory Questionnaire (SGRQ).
METHODS
We administered the CAT, CCQ and SGRQ in patients with COPD stage I-IV during three visits. Spirometry, 6 MWT, MRC scale, BODE index, and patients perspectives on questionnaires were recorded in all visits. Standard Error of Measurement (SEM) was used to calculate the Minimal Clinical Important Difference (MCID) of all questionnaires.
RESULTS
We enrolled 90 COPD patients. Cronbach's alpha for both CAT and CCQ was high (0.86 and 0.89, respectively). Patients with severe COPD reported worse health status compared to milder subgroups. CAT and CCQ correlated significantly (rho =0.64, p < 0.01) and both with the SGRQ (rho = 0.65; CAT and rho = 0.77; CCQ, p < 0.01). Both questionnaires exhibited a weak correlation with lung function (rho = -0.35;CAT and rho = -0.41; CCQ, p < 0.01). Their reproducibility was high; CAT: ICC = 0.94 (CI 0.92-0.96), total CCQ ICC = 0.95 (0.92-0.96) and SGRQ = 0.97 (CI 0.95-0.98). The MCID calculated using the SEM method showed results similar to previous studies of 3.76 for the CAT, 0.41 for the CCQ and 4.84 for SGRQ. Patients suggested both CAT and CCQ as easier tools than SGRQ in terms of complexity and time considerations. More than half of patients preferred CCQ instead of CAT.
CONCLUSIONS
The CAT and CCQ have similar psychometric properties with a slight advantage for CCQ based mainly on patients' preference and are both valid and reliable questionnaires to assess health status in COPD patients.
背景
健康状况提供了有价值的信息，与肺功能检查相辅相成，改善健康状况已成为 COPD 管理的重要治疗目标。我们比较了两种简单的问卷，COPD 评估测试（CAT）和临床 COPD 问卷（CCQ），与圣乔治呼吸问卷（SGRQ）相比，它们的有用性和有效性。
方法
我们在三次就诊期间对 COPD I-IV 期患者进行 CAT、CCQ 和 SGRQ 评估。在所有就诊中均记录了肺功能检查、6 分钟步行试验、MRC 量表、BODE 指数和患者对问卷的看法。使用标准测量误差（SEM）来计算所有问卷的最小临床重要差异（MCID）。
结果
我们纳入了 90 例 COPD 患者。CAT 和 CCQ 的克朗巴赫α系数均较高（分别为 0.86 和 0.89）。与较轻度亚组相比，重度 COPD 患者报告的健康状况更差。CAT 和 CCQ 呈显著相关（rho=0.64，p<0.01），且与 SGRQ 均呈显著相关（rho=0.65；CAT 和 rho=0.77；CCQ，p<0.01）。两个问卷与肺功能均呈弱相关（rho=-0.35；CAT 和 rho=-0.41；CCQ，p<0.01）。它们的可重复性均较高；CAT：ICC=0.94（CI 0.92-0.96），总 CCQ ICC=0.95（0.92-0.96）和 SGRQ=0.97（CI 0.95-0.98）。使用 SEM 方法计算的 MCID 与 CAT 为 3.76、CCQ 为 0.41 和 SGRQ 为 4.84 的先前研究结果相似。与 SGRQ 相比，患者认为 CAT 和 CCQ 在复杂性和时间考虑方面更容易。超过一半的患者更喜欢 CCQ 而不是 CAT。
结论
CAT 和 CCQ 具有相似的心理测量特性，CCQ 略占优势，主要基于患者的偏好，两者都是评估 COPD 患者健康状况的有效和可靠的问卷。
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