Establishing the Validity of Using the COPD Assessment Test to Screen for Fatigue in People With Chronic Obstructive Pulmonary Disease Referred to Pulmonary Rehabilitation.
Zoe Reizes, Renae J McNamara, Marita Dale and 1 others
PMID 37329503WHAT IT FOUND
A CAT score of 10 or higher correctly identified 95% of people with COPD who had clinically relevant fatigue.
However, it also flagged 69% of those without fatigue as having it. Use the CAT to screen for fatigue, but confirm the finding before treating.
Key findings
01A CAT-total score of 10 or higher had high sensitivity (0.95), correctly identifying 95% of participants with clinically relevant fatigue.
02The CAT-total score had low specificity (0.31), correctly identifying only 31% of participants who were not fatigued.
03The CAT-energy score alone had similar accuracy (85%) and specificity (0.31) but slightly lower sensitivity (0.93) than the total CAT score.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had a very high prevalence of fatigue (87%), which makes it difficult to assess how well the test identifies people who are truly not fatigued. The data came from a single hospital, so results may not apply to other settings. The design was retrospective, relying on existing assessment data rather than a controlled study setup. Fatigue was measured using self-reported questionnaires, which can be subjective.
The easy way to misread this
Do not assume a CAT score of 10 or higher definitively means the patient has clinically relevant fatigue. The test has low specificity, meaning it incorrectly identifies fatigue in many people who do not have it. Use the score as a prompt for further evaluation, not as a diagnosis.