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Browse ATS 2021 Abstracts

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ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

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Validation of the Chronic Airways Assessment Test in the NOVELTY Study

Session Title
TP18 - TP018 MEASUREMENT DEVELOPMENT, VALIDATION TOOLS, AND NOVEL OUTCOMES AMONG LUNG DISEASE
Abstract
A1661 - Validation of the Chronic Airways Assessment Test in the NOVELTY Study
Author Block: E. Tomaszewski1, M. J. Atkinson2, C. Janson3, N. Karlsson4, B. Make5, D. Price6, H. K. Reddel7, C. F. Vogelmeier8, H. Müllerová9, P. Jones10; 1BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, United States, 2Evidera, Bethesda, MD, United States, 3Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden, 4BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden, 5National Jewish Health and University of Colorado Denver, Denver, CO, United States, 6Observational and Pragmatic Research Institute, Singapore and Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom, 7Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia, 8Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, member of the German Center for Lung Research (DZL), Marburg, Germany, 9BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom, 10Global Respiratory Franchise, GlaxoSmithKline, Middlesex, United Kingdom.
Rationale: Very few patient-reported tools assess health status across different obstructive lung diseases. The Chronic Airways Assessment Test (CAAT) is a modification of the chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) that is intended to assess health status in patients with asthma and/or COPD. With permission, minor modifications were made to the CAT to replace the term ‘COPD’ with ‘chronic airways’ and ‘pulmonary disease’ in the questionnaire title and instructions, respectively. In all other respects the CAAT is the same as the CAT, including the wording of all items, response options, and the scoring. The CAAT score (range: 0-40) is the sum score of the 8 items (scored 0-5); higher scores indicate worse health status.
Methods: The CAAT was evaluated in patients with asthma and/or COPD using cross-sectional baseline data from NOVELTY (NCT02760329), a global, prospective, observational study. The total sample (N=1,530) for this validation analysis comprised three randomly-selected samples (N=510 each) from each physician-assigned diagnostic group (asthma, asthma+COPD, COPD). The total sample included a subset of patients who also completed the CAT (asthma+COPD: n=37; COPD: n=46). Psychometric analyses included descriptive statistics, tests of validity and reliability, and differential item functioning via Item Response Theory (IRT).
Results: CAAT items were internally consistent in each diagnostic group (Cronbach’s alphas ranged from 0.84 to 0.87; Table), a prerequisite for use as a single-factor tool in patients with asthma and/or COPD. Tests for convergent and divergent validity coefficients between the CAAT and clinical assessments found strong convergent correlations (>0.7) with health status assessed by the St. George’s Respiratory Questionnaire, and divergent (i.e. weak) correlations with some spirometry measures (Table). CAAT scores also differed significantly between clinically identifiable groups (physician-assigned diagnosis and physician-assessed severity groups, mMRC dyspnea scale grades, exacerbation history, and, in patients with an asthma diagnosis, Asthma Control Test scores). Furthermore, IRT analysis suggests that items had a good overall fit; item response boundary locations were monotonic and in the expected order. Models of measurement and structural invariance were strong.
Conclusions: Overall, this analysis demonstrates that the CAAT is a valid patient-reported tool with established cross-sectional psychometric properties. It correlated well with health status measures in NOVELTY patients with diagnoses of asthma and/or COPD. The CAAT is a suitable diagnosis-agnostic patient-reported tool for use in obstructive lung disease, and because of its brevity, may be particularly relevant for real-world clinical studies and routine clinical practice where time is limited.