A COPD assessment test (CAT) is a tool that can help you communicate the severity of your condition to your doctor.
People with chronic obstructive pulmonary disease (COPD) often have difficulties communicating with their doctors about their condition. Doctors, on the other hand, find it difficult to determine how much COPD is impacting their patients’ lives. The CAT tries to make this communication clearer and get patients and their doctors the information they need to manage this chronic condition.
This article will explore what the CAT entails, how doctors use it, and how you and your doctor can use it to help manage your COPD.
The CAT is a questionnaire that can help you and a doctor discuss the impact COPD has on your daily life.
It can be difficult to assign numeric values to many symptoms of COPD, such as shortness of breath or fatigue. Two people with the same level and severity of disease may perceive their experiences differently. How much those symptoms interfere with their daily activities may also differ.
The CAT asks questions about eight areas, prompting you to assign a score ranging from 0 to 5 for each area. A score of 0 means there’s no impairment in that area. A score of 5 means severe impairment.
Your overall score will range from 0 to 40. Higher scores indicate your COPD has a greater impact on your overall health and well-being.
The CAT correlates with the Global Initiative for Obstructive Lung Disease (GOLD) strategy, which outlines an evidence-based plan for assessing and managing COPD.
The CAT isn’t designed to diagnose COPD. It shouldn’t replace other types of testing for this condition such as spirometry and lung function testing.
A limitation of the test as a treatment tool is that it relies on each person’s perception of the impact of their COPD symptoms. Despite this limitation,
A doctor may ask you to complete this assessment online or in the form of a questionnaire before your appointment. The developers of CAT suggest that repeating the test every 2 to 3 months can help identify subtle changes in your disease that you might not notice otherwise.
As you complete the CAT, you’ll provide a score for eight different symptom areas and how severe you think they are. You’ll assign a 0 to items that have no impact on your life, and a 5 to items that have the most impact.
The CAT will ask you:
- how often you cough
- how much mucus is in your cough/chest
- how much tightness you feel in your chest
- how out of breath you feel after walking uphill or climbing stairs
- how much your condition limits your activities at home
- how comfortable or safe you feel leaving your home with COPD
- how well you’re able to sleep
- how much energy you have
Your CAT score is the total of your scores from the eight assessed areas. The maximum score is 40.
| Score | Impact | Meaning |
| 0–9 | Low | You may not experience many COPD symptoms, or at least not severe enough to affect your daily activities. Most days are good, but you cough regularly and get tired easily. |
| 10–20 | Medium | COPD symptoms affect your life regularly. You have some good days, but you get breathless easily and cough up phlegm regularly. You have 1 or 2 exacerbations each year. |
| 21–30 | High | Your symptoms regularly prevent you from doing things you want to do. Regular day-to-day activities like getting dressed are tiring. You don’t feel in control of your chest problem. |
| 31–40 | Very high | You never have any good days. It takes you a long time to complete even the simplest tasks. You feel like you can’t even leave the house. |
Generally, the GOLD guidelines suggest using a CAT score of 10 or above to indicate symptomatic COPD.
Doctors don’t use the CAT to diagnose COPD or decide on your treatment. Still, a higher score can signal that your COPD has a greater impact on your quality of life and prompt your doctor to repeat or review other types of tests or assessments.
Based on your CAT score, your doctor may make the following suggestions:
| Score | Impact | Guidance |
| 0–9 | Low | • If you smoke, consider quitting • Make sure you are vaccinated for flu, pneumonia, and COVID-19 • Avoid COPD triggers |
| 10–20 | Medium | • All guidance for low impact CAT scores • Pulmonary rehabilitation programs • Additional medications |
| 21–40 | High or very high | • All guidance for medium impact CAT scores • Referrals to pulmonary specialists |
The CAT score isn’t an official diagnostic tool, but it can help you and your doctor better understand and discuss the impact COPD has on your life as a whole. The questions on the test don’t measure specific symptoms. Rather, they measure how much those symptoms affect you daily.
An increasing score may not change your diagnosis, but it can indicate to your doctor when you need more help managing your condition.
