Department of Respiratory Medicine and Allergy, Tosei General Hospital, 489-8642, 160 Nishioiwake-cho, Seto City, Aichi, Japan.
Department of Respiratory Medicine and Allergy, Tosei General Hospital, 489-8642, 160 Nishioiwake-cho, Seto City, Aichi, Japan.
Respir Investig. 2024 Nov;62(6):1088-1093. doi: 10.1016/j.resinv.2024.08.006. Epub 2024 Sep 26.
Patients with fibrotic interstitial lung disease (FILD) have impaired health status. The simple questionnaire in the COPD assessment test (CAT) has been validated for idiopathic pulmonary fibrosis (IPF) and connective tissue disease-related interstitial lung disease (CTD-ILD), but no or limited data exist for patients with FILD as a whole. The aim of this study was to evaluate the reliability, repeatability and responsiveness of the CAT, and estimate the minimal clinically important difference (MCID) in patients with FILD.
This study was a retrospective chart review of 358 consecutive patients with FILD including 131 with IPF, who underwent clinical assessment over 6-12 month intervals. We assessed the cross-sectional and longitudinal validity of the CAT. MCID was estimated using distribution methods and anchor methods with mean change and regression models.
Internal consistency (Cronbach's alpha = 0.898) and repeatability (intraclass correlation coefficient [ICC] = 0.865) for the CAT score was acceptable. A cross-sectional study showed constructive validity. Changes in the CAT over 6-12 months were significantly associated with change in anchors including physiological function, exercise capacity, and dyspnea regardless of IPF diagnosis. The estimated MCIDs of the CAT for the deterioration and improvement directions were at least +5 and at least -3 points, respectively.
The CAT is a reliable, responsive and clinically relevant instrument for assessing health status in patients with FILD.
纤维化间质性肺疾病（FILD）患者的健康状况受损。COPD 评估测试（CAT）中的简单问卷已在特发性肺纤维化（IPF）和结缔组织疾病相关间质性肺疾病（CTD-ILD）中得到验证，但对于整个 FILD 患者，尚无或仅有有限的数据。本研究旨在评估 CAT 的可靠性、可重复性和反应性，并估计 FILD 患者的最小临床重要差异（MCID）。
这是一项回顾性图表研究，共纳入 358 例连续的 FILD 患者，其中 131 例为 IPF 患者，他们在 6-12 个月的时间间隔内接受了临床评估。我们评估了 CAT 的横断面和纵向有效性。使用分布方法和均值变化及回归模型的锚定方法来估计 MCID。
CAT 评分的内部一致性（Cronbach's alpha=0.898）和可重复性（组内相关系数[ICC]=0.865）是可以接受的。一项横断面研究显示了其结构有效性。CAT 在 6-12 个月的变化与包括生理功能、运动能力和呼吸困难在内的锚定点的变化显著相关，而不论 IPF 诊断如何。CAT 在恶化和改善方向上的估计 MCID 至少分别为+5 和至少-3 分。
CAT 是一种可靠、敏感且与临床相关的工具，可用于评估 FILD 患者的健康状况。
