Cross-sectional and longitudinal analysis of the COPD assessment test in a Canadian population of men and women with early and moderate-severe COPD
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background and objectives: The recently updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy recommends a new multidimensional approach for chronic obstructive pulmonary disease (COPD) assessment and management that now includes patient perceived disease impact. It proposes using the COPD Assessment Test (CAT) to measure the impact of COPD on wellbeing. This self-administered questionnaire provides a simple quantified measure of health-related quality of life (HRQoL). Summarising the current knowledge on the performance of this tool as a HRQoL measurement instrument is warranted, especially as the test could have important roles in COPD clinical practise and research.We aimed to systematically search the literature to evaluate the psychometric properties of the CAT (reliability, validity, responsiveness and minimum clinically important difference (MCID)) as a HRQoL instrument used in patients with COPD, and evaluate the validity of the CAT in specific patient population characteristics and measure the annual change in CAT score over 3 years.Methods: A systematic review was performed to assess the psychometric properties of the CAT in adults with COPD and to identify gaps within the literature concerning the questionnaire. The CAT was administered at baseline, 1.5 and 3 years to subjects with COPD in a population-based, prospective multicentre cohort study conducted throughout Canada. The CAT total score was determined for different levels of COPD disease stage, sex, age and smoking status. Mixed-effects linear models were used to estimate the relationship between the change in CAT score over the range of observed study years.Results: The systematic review identified 36 studies that evaluated CAT psychometric properties. Internal consistency (reliability) was 0.85â0.98 and test-retest reliability was 0.80â0.96. CAT total scores differed with GOLD stages and exacerbation. Mean scores decreased with pulmonary rehabilitation (2.2â3 units) and increased at exacerbation onset (4.7 units). Only one study with adequate methodology reported an MCID of 2 units and 3.3â3.8 units using the anchor-based approach and distribution-based approach, respectively. None of the studies conducted a longitudinal evaluation past 6 months.For the study in Canada, 643 subjects with COPD were included in the analysis. The mean CAT total score was 7.8 ± 6.6, 5.7 ± 5.0, 9.6 ± 6.7 and 14.9 ± 9.3 for all subjects, GOLD I, II and III+, respectively. Females scored higher than males in all GOLD grades, though it was only statistically significant in GOLD I and II. The interaction effect between year and GOLD stage demonstrated that the annual change in CAT score over 3 years differed among the three GOLD groups, particularly in GOLD III+ compared with GOLD I (Ã=-1.08, 95% CI (-2.02, -0.16)). The CAT score did not show any significant change over the study period of 3 years in each GOLD grade.Conclusions: Studies support the CAT's reliability, validity and responsiveness, however the MCID remains debatable. The characterisation of CAT scores in particular patient populations established that females scored higher than males in all GOLD grades. Three-year longitudinal follow-up could not show any significant change in CAT score among GOLD grades.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it