Comparative Study of Thai Validation COPD Symptom Assessment Tools: COPD Assessment Test (CAT), Modified Medical Research Council (mMRC) and Clinical COPD Questionnaire (CCQ) in Srinagarind Hospital
Pailin Ratanawatkul MD1, Piyaluck Virojsakul MD2, Worawat Chumpangern MD1, Apichart So-ngern MD3, Watchara Boonsawat MD1, Wipa Reechaipichitkul MD1
Affiliation : 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Resident of Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 3 Division of Sleep Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : To identify the discordance of the GOLD classification while using Thai validated COPD assessment test [CAT],
modified Medical Research Council [mMRC] and Clinical COPD Questionnaire [CCQ] assessing the patient’s symptoms.
Materials and Methods : This cross-sectional descriptive study was performed at the COPD clinic at Srinagarind Hospital,
Khon Kaen University from July 2015 to December 2016. Patients were allocated into each GOLD classification by using
the Thai validated CAT, mMRC and CCQ. The cut off points at CAT >10, mMMRC2 and CCQ 1.5 were used.
Results : Seventy-eight COPD patients were enrolled in this study. When using CAT, patients were allocated into GOLD A,
B, C and D at 52.56%, 8.97%, 19.23% and 19.23%. While using mMRC, the percentages were 50.0%, 11.54%, 24.36% and
14.10%, and 53.85%, 7.69%, 30.77% and 7.69% when CCQ was used. There were 70.51% of the patients that were
categorized into the same GOLD classifications when using these three scores. Kappa was 0.69 (95% CI, 0.11 to 0.71).
Conclusion : There was substantial concordance agreement in GOLD classifications whether CAT, mMRC or CCQ were
used. CCQ tended to allocate more patients into the lesser symptom group (GOLD A and C) than the other two scores.
Keywords : COPD, COPD assessment test [CAT], modified Medical Research Council [mMRC], Clinical COPD Questionnaire (CCQ)
