Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, McGill University, Montréal, QC, Canada Dept of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.
Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, McGill University, Montréal, QC, Canada.
Eur Respir J. 2014 Oct;44(4):873-84. doi: 10.1183/09031936.00025214. Epub 2014 Jul 3.
The COPD assessment test (CAT) is a self-administered questionnaire that measures health-related quality of life. We aimed to systematically evaluate the literature for reliability, validity, responsiveness and minimum clinically important difference (MCID) of the CAT. Multiple databases were searched for studies analysing the psychometric properties of the CAT in adults with chronic obstructive pulmonary disease. Two reviewers independently screened, selected and extracted data, and assessed methodological quality of relevant studies using the COSMIN checklist. From 792 records identified, 36 studies were included. The number of participants ranged from 45 to 6469, mean age from 56 to 73 years, and mean forced expiratory volume in 1 s from 39% to 98% predicted. Internal consistency (reliability) was 0.85-0.98, and test-retest reliability was 0.80-0.96. Convergent and longitudinal validity using Pearson's correlation coefficient were: SGRQ-C 0.69-0.82 and 0.63, CCQ 0.68-0.78 and 0.60, and mMRC 0.29-0.61 and 0.20, respectively. Scores differed with GOLD stages, exacerbation and mMRC grades. Mean scores decreased with pulmonary rehabilitation (2.2-3 units) and increased at exacerbation onset (4.7 units). Only one study with adequate methodology reported an MCID of 2 units and 3.3-3.8 units using the anchor-based approach and distribution-based approach, respectively. Most studies had fair methodological quality. We conclude that the studies support the reliability and validity of the CAT and that the tool is responsive to interventions, although the MCID remains debatable.
COPD 评估测试（CAT）是一种自我管理的问卷，用于衡量与健康相关的生活质量。我们旨在系统地评估文献中 CAT 在慢性阻塞性肺疾病成人中的可靠性、有效性、反应性和最小临床重要差异（MCID）。对多个数据库进行了搜索，以寻找分析 CAT 心理测量特性的研究。两位审稿人独立筛选、选择和提取数据，并使用 COSMIN 清单评估相关研究的方法学质量。从确定的 792 条记录中，纳入了 36 项研究。参与者人数从 45 人到 6469 人不等，平均年龄从 56 岁到 73 岁，平均 1 秒用力呼气量从预测值的 39%到 98%不等。内部一致性（可靠性）为 0.85-0.98，重测信度为 0.80-0.96。使用 Pearson 相关系数的收敛性和纵向有效性分别为：SGRQ-C 为 0.69-0.82 和 0.63，CCQ 为 0.68-0.78 和 0.60，mMRC 为 0.29-0.61 和 0.20。评分与 GOLD 分期、加重期和 mMRC 分级不同。平均分数随着 GOLD 分期的升高而升高，随着 mMRC 分级的升高而降低。只有一项方法学质量较好的研究报告了 MCID 为 2 个单位，使用锚定方法和分布方法分别为 3.3-3.8 个单位。大多数研究的方法学质量为中等。我们得出结论，这些研究支持 CAT 的可靠性和有效性，并且该工具对干预措施有反应性，尽管 MCID 仍存在争议。
