CHEST Guidelines-Repurposing-the-COPD-Assessment-Test

Repurposing-the-COPD-Assessment-Test_chest

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The editorial discusses the potential repurposing of the COPD Assessment Test (CAT) for patients with bronchiectasis, a chronic lung condition marked by persistent coughing, sputum production, and fatigue. Traditionally, symptoms of bronchiectasis have been known for 200 years, but there has been a growing recognition of how these symptoms impact patients' quality of life (QoL). Health-related quality of life (HRQoL) measures help in understanding patients’ perspectives on disease and treatment burden. <br /><br />The U.S. Food and Drug Administration (FDA) has emphasized patient-focused drug development, advocating for patient-reported outcome (PRO) measures that accurately reflect patients’ experiences without intermediary interpretation by physicians. Current HRQoL tools, like the Quality of Life-Bronchiectasis (QOL-B), meet FDA standards, but challenges remain. These tools sometimes lack uniform performance and encounter issues like lengthy administration or recall bias.<br /><br />The CAT, originally used for COPD, is an eight-item questionnaire indicating QoL impact and has shown promise in the bronchiectasis population as well, according to patient interviews that highlighted its simplicity and effectiveness. Two validation studies from the UK and Spain evaluated the CAT, demonstrating strong reliability, convergent validity, and responsiveness in assessing bronchiectasis. Findings indicate the CAT correlates well with other PRO measures, can indicate disease severity, predict exacerbations, and has a determined minimum clinically important difference (MCID) of 3-4.<br /><br />Yet, questions endure regarding the effectiveness of CAT across bronchiectasis’ diverse phenotypes and the optimal frequency for its administration. Despite these uncertainties, the editorial praises the advancement in understanding bronchiectasis using the CAT, spotlighting the tool's potential to fill knowledge gaps for patients, researchers, and physicians.

Keywords

COPD Assessment Test

bronchiectasis

patient-reported outcomes

health-related quality of life

FDA standards

Quality of Life-Bronchiectasis

validation studies

disease severity

minimum clinically important difference

phenotypes