Chest
Original ResearchCOPDClinical Application of the COPD Assessment Test: Longitudinal Data From the COPD History Assessment in Spain (CHAIN) Cohort
Section snippets
Participants
CHAIN is a Spanish multicenter study carried out in pulmonary clinics and includes active and former smokers with COPD and a control group of patients without COPD. COPD was defined by a history of smoking of at least 10 pack-years and an FEV1/FVC < 0.70 after 400 μg inhaled albuterol. The main goal of this prospective observational study is to perform a multidimensional evaluation of the evolution of patients with COPD to better define the natural history and phenotypes of the disease. The
Results
A total of 824 smokers with COPD and 126 smokers without COPD were evaluated at baseline. Their clinical and physiologic characteristics are provided in Table 1. This mainly middle-aged male population of patients with COPD had a median smoking history of 50 pack-years (one-third still smoked) and represented all degrees of airway obstruction with few comorbidities and hospital admissions. The patients with COPD had mild symptomatic impairment, with a median mMRC scale score of 1; median CAT
Discussion
This 1-year longitudinal observational study of a well-characterized cohort of patients with stable COPD who were maintained on the same treatment demonstrated that changes in CAT scores are associated only with changes in the degree of dyspnea measured by the mMRC scale. The 1-year longitudinal CAT scores of patients with stable COPD exhibited variability similar to that of their mMRC scale scores or the CAT scores in smokers who lacked airway obstruction. The mMRC scale and CAT perform
Acknowledgments
Author contributions: J. P. d. T. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. J. P. d. T., J. M. M., P. d. L.-R., G. P.-B., J. J. S.-C., J. L. L.-C., J. B. S., and C. C. contributed to study concept and design; J. P. d. T., J. M. M., C. M.-G., P. d. L.-R., I. M.-V., B. C., G. P.-B., M. C.-R., I. S.-G., R. A. B., A. d. D.-D, N. F.-C., I. A. M., R. I., E. B., A. L. C., J. B. G. I., M. M. R., J. J.
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2018, Respiratory MedicineCitation Excerpt :There are a number of strengths in our study, including novelty, size, and length of follow-up. Further, patients represent well the full range of COPD patients seen in a universal, free for all health system [27–31]. Also, our graphical representation with a sophisticated Markov methodology is within the first in clinical research.
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2018, Respiratory MedicineCitation Excerpt :Similarly, the cut offs suggested for CAT and CCQ scores seem to be very restrictive as less than 50% of patients could be considered as having low impact according to their questionnaire scores. Although the CAT score has been demonstrated to be the best predictor of the risk of future exacerbations compared with other PROs [22], the best threshold for increased risk is yet to be defined [23,24]. In the previous database study using the OPCRD, the authors could not identify a value of the CAT score with enough predictive value for future exacerbations [21].
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2017, Journal of the American Medical Directors AssociationCharacteristics of patients with increasing COPD assessment test scores within 3 years
2017, Respiratory MedicineCitation Excerpt :COPD patients with ΔCAT score/year ≥2 were older and had more severe airflow limitation and emphysema at baseline than those with ΔCAT score/year <2. Unlike a previous report [11], this study showed that ΔCAT score/year was negatively correlated with baseline CAT, albeit weakly. This suggested that one random CAT score would not necessarily predict the trend of yearly changes in CAT scores, although the usefulness of CAT has been well established for real-time comprehensive assessment of COPD status [2,6].
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*A complete list of CHAIN participants in available in e-Appendix 1.
FUNDING/SUPPORT: The PII SEPAR de EPOC endorsed this study. AstraZeneca provided partial funding for this study.
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