P146 Validation of the COPD assessment test (CAT) in pulmonary rehabilitation: application to a cohort of mixed pulmonary diseases

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The CAT is a new self administered questionnaire developed and validated for the assessment and monitoring of COPD patients.1 Recently, it has been showed to be sensitive to pulmonary rehabilitation (PR) in a prospective multicentric COPD study.2 The CAT has never been validated in a global PR programme with mixed pulmonary diseases.


We performed a retrospective study of 30 patients who completed the CAT before and after PR in 2010–2011. The cohort included seventeen patients diagnosed with COPD, seven with asthma and six with fibrosis. All participants were referred for an 8 weeks, three times weekly rehabilitation programme. Our primary objective was to validate the CAT in the cohort. We also evaluated six other outcome measures of PR as a secondary endpoint (Abstract P146 table 1). Pre and post PR variations were calculated with a nonparametric Wilcoxon test and Spearman rank correlation test was used to assess the relationship between measures.


The CAT decreased significantly by a mean of 3.2 (p<0.01) following PR. The mean CAT score change was similar in all pulmonary disease groups and between obstructive and non obstructive diseases. The pre and post CAT score negative variation was 4.16 (p<0.05) for women, 3.74 (p<0.05) for patients younger than 70 years old and 4.41 (p<0.05) for patients with <1 exacerbation yearly. No correlation between the CAT score change and the FEV1 (r=−0.11) was found. Of all the outcome measures, the number of climb stairs was the most responsive with an amelioration of 250% after PR.


Even if the CAT was initially developed for the assessment of COPD patients, our study has shown that the questionnaire is responsive to a chronic lung disease's population undergoing rehabilitation. A prospective study is now required to expand the application of the CAT to the general assessment of patients with chronic lung diseases.

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