Vos, A.W. (2013) Vergelijking van de psychometrische eigenschappen van de COPD Assessment Test (CAT) en de Clinical COPD Questionnaire (CCQ) in nieuw gediagnosticeerde COPD-patiënten. thesis, Medicine.
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Abstract
Background: The treatment of COPD is among others aimed at improving health status. The most important questionnaire to measure health status in COPD is the St. George’s Respiratory Questionnaire (SGRQ). Unfortunately this questionnaire is too long and complex to be used in daily practice. The Clinical COPD Questionnaire (CCQ) is easy to use in daily practice but has never been widely used outside of Holland. The COPD Assessment Test, developed in 2009, is known internationally and can be used in daily practice. In this research the psychometric characteristics of the CAT and CCQ were compared in a group of patients who were newly diagnosed with COPD. Methods: In a prospective validation study, the criterium validity, internal consistency, reproducibility (agreement and reliability) and floor- and ceiling effects of the CAT and CCQ were investigated. The research took place at the outpatient ward of the Isala Klinieken in Zwolle, the Netherlands. Results: There were 51 patients in the study, with an average age of 68,4 (9,4), of whom 60,8% were male. In the sample 49% of patients belonged to GOLD-stage II and 51% to GOLD-stage III. The mean average score on the SGRQ was 38,9 with standard deviation 2,3. The median of the CAT score was 16,0 with an interquartile range of 12,0. The median of the CCQ was 1,5 with and interquartile range of 1,5. The SGRQ and CAT had a correlation of 0,85 (p < 0,01), the SGRQ and CCQ a correlation of 0,89 ( p < 0,01) and a correlation of 0,89 (p < 0,01) was found between the CAT and CCQ. Both questionnaires were unable to discriminate GOLD II from GOLD III. Internal consistency was high with a Cronbach’s α of 0,85 for the CAT and of 0,90 for the CCQ. Bland Altman plots, made in stable patients in week 2, showed small differences between scores for both the CAT and CCQ. Unfortunately the limits of agreement were very wide for both questionnaires. The Intraclass Correlation Coefficients were high. The CAT had an ICC of 0,89 with an 95% confidence interval from 0,79 to 0,93 (p < 0,0001). The CCQ had an ICC of 0,87 with and 95% confidence interval from 0,77 to 0,92 (p < 0,0001). Responsiveness, shown as Area Under the Curve (AUC) of a Receiver Operating Characteristics Curve (ROC-curve), was poor for both questionnaires. The AUC of the difference scores on the CAT was 0,58 and for the CCQ was 0,59. There was no evidence of floor- or ceiling effects. Conclusion: The psychometric characteristics of the CAT and the CCQ were comparable. Both the CAT and CCQ had a good criterium validity, internal consistency en reproducibility. There were nog floor- or ceiling effects. The responsiveness of both the CAT and CCQ was insufficient. This may be explained by the response shift theory, that may play a large role in this sample of newly diagnosed COPD-patients. Both questionnaires were unable to discriminate GOLD II from GOLD III. In contrast with the use in stable patients, the CAT and CCQ may be of limited use in newly diagnosed COPD-patients.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Berg, J.W.K. van den and Uil, S.M. and Isala Klinieken Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2153 |
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