title: The COPD Assessment Test (CAT): short- and medium-term response to pulmonary rehabilitation.
abstract: BACKGROUND
  The COPD Assessment Test (CAT) is a recently introduced instrument to assess health-related quality of life in COPD. We aimed to evaluate the longitudinal change in CAT following Pulmonary Rehabilitation (PR), and test the relationship between CAT and CRQ-Self Report (SR) over time. We hypothesised that the CAT would show similar responsiveness to PR as the CRQ-SR both in the short and medium-term.
  
  
  METHODS
  118 COPD patients completed an eight-week outpatient multidisciplinary PR programme. CAT, CRQ-SR and the incremental shuttle walk (ISW) were measured prior to starting PR (T1), completion of PR (T2) and 6 months after completion of PR (T3).
  
  
  RESULTS
  There was a significant improvement in CAT, CRQ-SR and ISW immediately following PR (p < 0.001). Although there was decline between T2 and T3, CAT, CRQ-SR and ISW remained significantly better at T3 compared with T1 (ANOVA p < 0.001). Both between T1-T2 and between T2-T3, change in CAT correlated significantly with change in CRQ (both r = -0.44 and p < 0.001). The slope of the relationship between CAT change and CRQ-SR change at T1-T2 and T2-T3 was not significantly different (ANCOVA: intercept p = 0.79, interaction effect p = 0.95).
  
  
  CONCLUSIONS
  In COPD, the CAT score is immediately responsive to PR and remains improved at 6 months. There is no significant difference in the short and medium term changes in the CAT and CRQ-SR following PR. We propose that for most clinical indications for assessing health-related quality of life in COPD, the CAT is a robust and practical alternative to longer-established instruments such as the CRQ-SR.
authors.affiliation: St George's University of London, Clinical Sciences, Cranmer Terrace, Tooting, United Kingdom.
authors.forename: James W
authors.initials: JW
authors.lastname: Dodd
authors.forename: Phillippa L
authors.initials: PL
authors.lastname: Marns
authors.forename: Amy L
authors.initials: AL
authors.lastname: Clark
authors.forename: Karen A
authors.initials: KA
authors.lastname: Ingram
authors.forename: Ria P
authors.initials: RP
authors.lastname: Fowler
authors.forename: Jane L
authors.initials: JL
authors.lastname: Canavan
authors.forename: Mehul S
authors.initials: MS
authors.lastname: Patel
authors.forename: Samantha S C
authors.initials: SS
authors.lastname: Kon
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Hopkinson
authors.forename: Michael I
authors.initials: MI
authors.lastname: Polkey
authors.forename: Paul W
authors.initials: PW
authors.lastname: Jones
authors.forename: William D-C
authors.initials: WD
authors.lastname: Man
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome