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A Study of the Normative Values for the CAT Questionnaire in the Healthy Indian Population
October 2015, Vol 148, No. 4_MeetingAbstracts
Obstructive Lung Diseases | October 2015
A Study of the Normative Values for the CAT Questionnaire in the Healthy Indian Population Radhika Banka; Sarika Bhosale; Lalita Angne; Matthew Shorofsky; Jean Bourbeau; Lancelot Pinto P D Hinduja Hospital & Medical Research Centre, Mumbai, India Chest. 2015;148(4_MeetingAbstracts):702A. doi:10.1378/chest.2279408
Abstract SESSION TITLE: COPD Posters III SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: The COPD assessment test (CAT), a patient-filled questionnaire, is recommended as part of the assessment of individuals with COPD. CAT scores have shown ethnic and gender variations among normal individuals, and CAT scores in the non-COPD population (normative values) have not been studied in the Indian population. The purpose of this study was to determine the normative values and psychometric properties of the CAT questionnaire. METHODS: The P.D.Hinduja Hospital,Mumbai is a tertiary care center that caters to the population of the city. Between Dec 2014- Feb 2015, consecutive subjects undergoing spirometry as part of an annual health screening at P.D.Hinduja Hospital, Mumbai, India were enrolled to fill up CAT questionnaires. Spirometry was conducted by trained technicians using ATS criteria for quality control. The Udwadia et al. reference equation for Indian subjects was used to define predicted spirometric values. Among nonCOPD subjects (postbronchodilator FEV1/FVC ≥ 0.7), normative values for the CAT questionnaire, and psychometric properties of the test were characterized. RESULTS: Of 326 subjects undergoing health check-up, 288 non-COPD subjects were included. Mean FEV1/FVC ratio was 0.80 (SD 0.49); mean predicted FEV1 was 98.4%(SD 15). Overall mean CAT score was 9.14 (SD 6.68); higher among females (9.1, SD 7) than males (9.21, SD 6.09), and higher in subjects over 60 years of age (mean 9.49, SD 7.39). Cronbach alpha for the CAT was 0.84, suggesting high internal consistency. 116 (40%) subjects had a CAT score ≥ 10. In the univariate analysis, body mass index (p=0.06) and current smoking (p=0.001) were associated with a CAT score ≥ 10. In the multivariate analysis, current smoking was the only variable that was statistically significantly associated with a CAT score ≥ 10 (p=0.001). CONCLUSIONS: Indians appear to have higher normative values than populations in developed countries. In the adjusted analysis, current smokers had higher CAT scores, suggesting a causal, rather than a cultural reason for high normative values. CLINICAL IMPLICATIONS: South Asians are known to have the poorest lung functions in the world. Whether the higher normative CAT scores are a reflection of poorer quality of life, and whether the reference equations for spirometry need to be based on longitudinal outcomes rather than population distribution are research areas that need to be explored further. Acknowledgement: The study was funded by “Project Québec-Maharashtra, Relations internationales et de la Francophonie, Quebec”. DISCLOSURE: The following authors have nothing to disclose: Radhika Banka, Sarika Bhosale, Lalita Angne, Matthew Shorofsky, Jean Bourbeau, Lancelot Pinto
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Obstructive Lung Diseases | October 2015
A Study of the Normative Values for the CAT Questionnaire in the Healthy Indian Population Radhika Banka; Sarika Bhosale; Lalita Angne; Matthew Shorofsky; Jean Bourbeau; Lancelot Pinto P D Hinduja Hospital & Medical Research Centre, Mumbai, India Chest. 2015;148(4_MeetingAbstracts):702A. doi:10.1378/chest.2279408
Abstract SESSION TITLE: COPD Posters III SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: The COPD assessment test (CAT), a patient-filled questionnaire, is recommended as part of the assessment of individuals with COPD. CAT scores have shown ethnic and gender variations among normal individuals, and CAT scores in the non-COPD population (normative values) have not been studied in the Indian population. The purpose of this study was to determine the normative values and psychometric properties of the CAT questionnaire. METHODS: The P.D.Hinduja Hospital,Mumbai is a tertiary care center that caters to the population of the city. Between Dec 2014- Feb 2015, consecutive subjects undergoing spirometry as part of an annual health screening at P.D.Hinduja Hospital, Mumbai, India were enrolled to fill up CAT questionnaires. Spirometry was conducted by trained technicians using ATS criteria for quality control. The Udwadia et al. reference equation for Indian subjects was used to define predicted spirometric values. Among nonCOPD subjects (postbronchodilator FEV1/FVC ≥ 0.7), normative values for the CAT questionnaire, and psychometric properties of the test were characterized. RESULTS: Of 326 subjects undergoing health check-up, 288 non-COPD subjects were included. Mean FEV1/FVC ratio was 0.80 (SD 0.49); mean predicted FEV1 was 98.4%(SD 15). Overall mean CAT score was 9.14 (SD 6.68); higher among females (9.1, SD 7) than males (9.21, SD 6.09), and higher in subjects over 60 years of age (mean 9.49, SD 7.39). Cronbach alpha for the CAT was 0.84, suggesting high internal consistency. 116 (40%) subjects had a CAT score ≥ 10. In the univariate analysis, body mass index (p=0.06) and current smoking (p=0.001) were associated with a CAT score ≥ 10. In the multivariate analysis, current smoking was the only variable that was statistically significantly associated with a CAT score ≥ 10 (p=0.001). CONCLUSIONS: Indians appear to have higher normative values than populations in developed countries. In the adjusted analysis, current smokers had higher CAT scores, suggesting a causal, rather than a cultural reason for high normative values. CLINICAL IMPLICATIONS: South Asians are known to have the poorest lung functions in the world. Whether the higher normative CAT scores are a reflection of poorer quality of life, and whether the reference equations for spirometry need to be based on longitudinal outcomes rather than population distribution are research areas that need to be explored further. Acknowledgement: The study was funded by “Project Québec-Maharashtra, Relations internationales et de la Francophonie, Quebec”. DISCLOSURE: The following authors have nothing to disclose: Radhika Banka, Sarika Bhosale, Lalita Angne, Matthew Shorofsky, Jean Bourbeau, Lancelot Pinto
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