How to Take a COPD Assessment Test (CAT)

This simple self-evaluation can tell you a lot about your condition

Senior woman at doctor's office.
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There are a number of questionnaires that doctors use to assess the severity and impact of chronic obstructive pulmonary disease (COPD). One of them is called the COPD assessment test, also known as the CAT. It is comprised of eight questions in which patients rate both their symptoms and the relative level of impairment.

Use and Benefits

The CAT is heralded as a quick, easy, and painless way to get an objective look at how COPD impacts your life. Ultimately, it can help improve your patient-doctor communication about the disease.

Some clinicians have not adopted the CAT in their daily practice, citing studies showing that using the test is not an effective way to evaluate the measure of lung function—that it only provides a look at the disease's impact on a person's health status. However, many clinicians do use it, largely because of an evolution in thought about the value of diagnostic testing. Some studies also suggest that CAT may be useful in predicting the risk of exacerbations, the development of depression, and the progression of symptomatic disease.

Beyond Diagnostic Testing

The year 2011 was characterized by a sea change in how COPD was approached, medically speaking. It was then that the scientific committee of the Global Initiative for Obstructive Lung Disease (GOLD) issued recommendations stating that COPD should no longer be treated based solely on diagnostic tests like spirometry. The GOLD committee recognized that these tests, while valuable, had shortcomings in their ability to assess what a person was experiencing.

In some cases, for example, a person with COPD may be diagnosed with minor impairment but be unable to walk up a flight of stairs. By contrast, a person with moderate impairment may function more normally than diagnostic tests were able to suggest.

The updated guidelines acknowledged that the expression of COPD is based on many intersecting factors, including the restriction of respiratory function, the frequency of exacerbations, and the person's own perception of their illness.

The CAT helps quantify these factors based on a patient's experience.

How the CAT Works

The COPD assessment test is both simple and highly descriptive. The eight questions are each rated on a scale of 0 to 5. The numbers are then tallied for a score of 0 to 40. The higher the number, the more serious the impairment.

The range of questions is related to different aspects of the disease as follows:

Symptom in Question CAT Answer Ranges (0-5)
Cough "I never cough" (0) to "I cough all the time" (5)
Mucus "I have no mucus at all" (0) to "my chest is completely full of mucus" (5)
Chest tightness "My chest does not feel tight at all" (0) to "my chest feels very tight" (5)
Shortness of breath "When I walk up one flight of stairs, I am not breathless" (0) to "when I walk up one flight of stairs, I am very breathless" (5)
Activity restriction at home "I am not limited doing any activities at home" (0) to "I am very limited doing activities at home" (5)
Activity restriction outside of the home "I am confident leaving my home despite my lung condition" (0) to "I am not at all confident leaving my home because of my lung condition" (5)
Impact on sleep "I sleep soundly" (0) to "I don’t sleep soundly because of my lung condition" (5)
Impact on energy "I have lots of energy" (0) to "I have no energy at all" (5)

How to Take the Test

You can take the CAT at home by printing it out from the official CAT website, where it is available as a free download in 57 different languages. After you complete the test, bring your responses to your next doctor's appointment to discuss them.

You may also request to take the test in its entirety at your doctor's office and review the results right there and then.

Results and Next Steps

While the CAT is not used to diagnose COPD and cannot replace COPD treatments, it is valuable in determining when treatment should be started, how many treatments should be prescribed, and how well or poorly a person is responding to treatment.

Based on the GOLD guidelines:

  • Persons with CAT scores higher than 10 should receive daily therapy as soon as possible.
  • Any upward trend is considered a deterioration in one's condition.
  • Any downward trend is considered an improvement.
  • Any increase of more than two points, either up or down, is considered a significant change in symptom control.

It may be helpful to take the CAT every few months, to get an idea of how your condition changes over time and with different treatment options.

A Word From Verywell

The CAT is a simple, noninvasive test that can give both you and your doctor quantitative insight into your COPD condition and see how well you're responding to care. While taking this test can't help you diagnose the disease, it's a great, free tool to use if you've been battling the condition that can help you monitor your therapy.

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