COPD Assessment Test May Help Determine Severity of Bronchiectasis

The chronic obstructive pulmonary disease (COPD) assessment test proved to be valid and reproducible in assessing the effect and severity of bronchiectasis symptoms in patients with COPD, according to a study published in the Journal of Chronic Obstructive Pulmonary Disease.

Researchers analyzed the accuracy of the brief COPD assessment test questionnaire on detecting the severity of bronchiectasis, dyspnea, aerobic and functional capacity, and physical activity. Patients in this cross-sectional study were evaluated using the COPD assessment test, a respiratory questionnaire, an activity-based questionnaire, and spirometry and exercise assessments on visit 1 and visit 2 (7-10 days later). The severity of bronchiectasis was determined using an E-FACED score, which consists of ≥1 exacerbation in the previous year, forced expiratory volume in 1 second, age, Pseudomonas aeruginosa chronic colonization, extension (ie, number of lobes affected), and dyspnea.

Of the 100 participants included in this study, 59 were women, the average age was 48±14 years, the average body mass index was 24.1 kg/m², the average forced vital capacity was 67.0% of predicted value, and the forced expiratory volume was 51.9% of predicted value. Regarding activity level, 64.0% of the participants were categorized as sedentary or with low physical activity and 36.0% were categorized as active.

The E-FACED scores indicated that 56% of patients experienced mild disease impact, 39% experienced moderate disease impact, and 5% experienced severe disease impact. The COPD assessment test indicated that 14% had low impact, 40% had medium impact, 31% had high impact, and 15% had very high impact of disease. Patients who scored lower on both the E-FACED and COPD assessment test scored better in quality of life and physical activity evaluations.

The mean scores from COPD assessment test visits 1 and 2 were not different (21 vs 19, respectively, P =.20), the intraclass correlation coefficient was 0.84 (95% CI, 0.78-0.89, P <.001) which showed reliability, and the Bland Altman value indicated a mean bias and limits of agreement of 0.7 (95% CI, –8.7 to 10.1). There were significant correlations between COPD assessment test scores and Saint George Respiratory Questionnaire total scores (r=0.74), E-FACED scores, bronchiectasis severity index, number of steps taken per day, forced vital capacity (r=–0.33, P =.001), and forced expiratory volume (r=–0.28, P =.004).

The researchers noted that future studies need to expand on study population to include a wider variety in demographics and to perform disease-specific, health-related quality-of-life questionnaires.

The COPD assessment test is a valid and reproducible tool to evaluate the affect bronchiectasis symptoms have on the daily life of patients with the disease, and that it is “an easy-to-use, easy-to-understand, quick, and a useful tool for assessment of the impact of bronchiectasis on patients’ life and may play an important role in both daily medical practice and clinical trial settings,” the researchers concluded.

Reference

Lanza FC, Castro RAS, de Camargo AA, et al. COPD assessment test (CAT) is a valid and simple tool to measure the impact of bronchiectasis on affected patients [published online November 23, 2018]. COPD. doi:10.1080/15412555.2018.1540034