Chronic Airways Assessment Test: psychometric properties in patients with asthma and/or COPD
Erin Tomaszewski, Mark J. Atkinson, Christer Janson, Niklas Karlsson, Barry J. Make, David Price, Helen K. Reddel, Claus Vogelmeier, Hana Müllerová, Paul Jones, NOVELTY Scientific Community;, Ricardo del Olmo, Gary P. Anderson, Helen K. Reddel, Marcelo Fouad Rabahi, Andrew McIvor, Mohsen Sadatsafavi, Ulla Weinreich, Pierre‐Régis Burgel, Gilles Devouassoux, Alberto Papi, Hiromasa Inoue, Adrián Rendón, Maarten van den Berge, Richard Beasley, Alvar Agustí García-Navarro, Rosa Faner, José Olaguibel Rivera, Christer Janson, Magdalena Bilińska-Izydorczyk, Malin Fagerås, Titti Fihn-Wikander, Stefan Franzén, Christina Keen, Kristoffer Ostridge, James D. Chalmers, Timothy Harrison, Ian Pavord, David Price, Adnan Azim, Laura Belton, François-Xavier Blé, Clement Erhard, Kerry Gairy, Rod Hughes, Glenda Lassi, Hana Müllerová, Eleni Rapsomaniki, Ian Scott, Bradley E. Chipps, Barry J. Make, Stephanie A. Christenson, Erin Tomaszewski, NOVELTY study investigators, Ricardo del Olmo, Gabriel Benhabib, Xavier Bocca Ruiz, Raúl Lisanti, Gustavo Marino, Walter Mattarucco, Juan Nogueira, Maria Parody, Pablo Pascale, Pablo Rodriguez, Damian Silva, Graciela Svetliza, Carlos Victorio, Roxana Willigs Rolon, Anahí Yáñez, Helen K. Reddel, Stuart Baines, Simon Bowler, Peter Bremner, Sheetal Bull, Patrick Carroll, Mariam Chaalan, Claude S. Farah, Gary Hammerschlag, Kerry Hancock, Zinta Harrington, Gregory Katsoulotos, Joshua Kim, David Langton, Donald Lee, Matthew Peters, Lakshman Prassad, Dimitar Sajkov, Francis Santiago, Frederick Graham Simpson, Sze Tai, Paul S. Thomas, Peter Wark, Marcelo Fouad Rabahi, José Eduardo Delfini Cançado, Thúlio Cunha, Marina Andrade Lima, Alexandre Pinto Cardoso, J Mark FitzGerald, Andrew McIvor, Syed Anees
Abstract
BACKGROUND: No short patient-reported outcome (PRO) instruments assess overall health status across different obstructive lung diseases. Thus, the wording of the introduction to the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) was modified to permit use in asthma and/or COPD. This tool is called the Chronic Airways Assessment Test (CAAT). METHODS: The psychometric properties of the CAAT were evaluated using baseline data from the NOVELTY study (NCT02760329) in patients with physician-assigned asthma, asthma + COPD or COPD. Analyses included exploratory/confirmatory factor analyses, differential item functioning and analysis of construct validity. Responses to the CAAT and CAT were compared in patients with asthma + COPD and those with COPD. RESULTS: CAAT items were internally consistent (Cronbach's alpha: > 0.7) within each diagnostic group (n = 510). Models for structural and measurement invariance were strong. Tests of differential item functioning showed small differences between asthma and COPD in individual items, but these were not consistent in direction and had minimal overall impact on the total score. The CAAT and CAT were highly consistent when assessed in all NOVELTY patients who completed both (N = 277, Pearson's correlation coefficient: 0.90). Like the CAT itself, CAAT scores correlated moderately (0.4-0.7) to strongly (> 0.7) with other PRO measures and weakly (< 0.4) with spirometry measures. CONCLUSIONS: CAAT scores appear to reflect the same health impairment across asthma and COPD, making the CAAT an appropriate PRO instrument for patients with asthma and/or COPD. Its brevity makes it suitable for use in clinical studies and routine clinical practice. TRIAL REGISTRATION: NCT02760329.