Evaluating the Effectiveness of the COPD Assessment Test (CAT) in Screening for Chronic Obstructive Pulmonary Disease

Abstract

Nadia Al Wachami,1 Karima Boumendil,1 Maryem Arraji,1 Younes Iderdar,1 Yassmine Mourajid,1 Nadia Ghosne,2 Ali Benmoussa,3 Mohamed Khalis,4– 6 Amal Korrida,7,8 Fatima Zahra Laamiri,1 Halima Lajane,2 Mohamed Lahbib Louerdi,9 Saad El Madani,1 Mohamed Chahboune1 1Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Settat, 26000, Morocco; 2Higher Institute of Nursing Professions and Health Techniques (ISPITS), Casablanca, Morocco; 3Higher Institute of Nursing Professions and Health Techniques (ISPITS), Meknès, Morocco; 4Mohammed VI Center of Research and Innovation, Rabat, Morocco; 5International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco; 6Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco; 7Higher Institute of Nursing Professions and Health Techniques (ISPITS), Agadir, Morocco; 8Research Laboratory of Innovation in Health Sciences (LARISS), Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco; 9Provincial Delegation of health, Settat, 26000, MoroccoCorrespondence: Nadia Al Wachami, Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Settat, 26000, Morocco, Tel [phone], Email [email protected]: Chronic obstructive pulmonary disease (COPD) is a major public health problem that remains largely under-diagnosed, mainly due to the under-use of spirometry to establish the diagnosis. The aim of this study is to evaluate the effectiveness of the Moroccan Arabic dialect version of the COPD Assessment Test (CAT) in screening for COPD.Methods: This was a cross-sectional study carried out in primary care facilities in Morocco, involving participants aged 40 and over. The performance of CAT in detecting cases of COPD was measured with reference to the results of spirometry, considered to be the gold Standard.Results: A total of 477 participants were included in the study. The prevalence of COPD was 6.7%. Internal consistency of the Moroccan Arabic dialect version of the CAT was high, with a Cronbach’s alpha of 0.89. The total score of the CAT and of each item was significantly higher in subjects with COPD than in those without (P=0.000). Significantly negative correlations were found between CAT total score and FEV1 (r = − 0.33, p=0.000), CAT and FVC (r = − 0.22, p=0.000), CAT and FEV1/FVC ratio (r = − 0.22, p=0.000). The receiver operating characteristic curve showed an area under the curve of 0.93. A CAT score of 10 was the optimal cut-off value for COPD screening, with a sensitivity, specificity, positive predictive value, and negative predictive value of 78.1%, 93.9%, 48.1% and 98.4%, respectively.Conclusion: The results of the present study showed that the CAT could be used as a screening tool for COPD. The use of this tool by healthcare professionals in primary care settings will improve and promote early diagnosis of this chronic disease.Keywords: chronic obstructive pulmonary disease, COPD assessment test, screening, primary care

Keywords

• chronic obstructive pulmonary disease
• copd assessment test
• screening
• primary care