Utility of COPD Assessment Test (CAT) in primary care consultations: a randomised controlled trial.
Utility of COPD Assessment Test (CAT) in primary care consultations: a randomised controlled trial.
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DOI：
10.4104/pcrj.2013.00001
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发表时间：
2013-03
期刊：
影响因子：
--
通讯作者：
Jones P
中科院分区：
文献类型：
--
作者：
Gruffydd-Jones K;Marsden HC;Holmes S;Kardos P;Escamilla R;Dal Negro R;Roberts J;Nadeau G;Vasselle M;Leather DA;Jones P
COPD 评估测试 (CAT) 的目的之一是帮助医生和患者就慢性阻塞性肺疾病 (COPD) 对患者生活的负担进行沟通。调查 CAT 对 COPD 患者初级保健咨询质量的影响。欧洲各地的初级保健医生对标准化慢性阻塞性肺病患者（由训练有素的演员扮演）进行了六次咨询。在会诊期间，医生被随机安排看诊已完成 CAT（CAT+ 臂）或未完成 CAT（无 CAT 臂）的患者。这些都被录像，独立评估员对医生识别和解决抑郁症等患者特定问题的能力进行评分（A 分）；审查标准 COPD 问题，例如呼吸困难（B 分）；他们对案件的理解（理解分数）；以及他们的整体表现。主要终点是总体评分（分项评分 A+B；量表范围 0-40）。共有 165 名医生参加了这项研究，每人进行了 6 次咨询； 882 次咨询被认为适合分析。各组之间在总体评分（无 CAT 组 20.3；CAT+ 组 20.7；95% CI -1.0 至 1.8；p=0.606）或子评分 A（p=0.255）方面未见差异。尽管临床相关性有限，但在平均分值 B 中观察到了统计学上的显着差异（无 CAT 组 8.8；CAT+ 组 9.6；95% CI 0.0 至 1.6；p=0.045）。理解分数 (p=0.824) 或整体表现 (p=0.655) 没有差异。 CAT 是一种特定于疾病的工具，可帮助医生评估 COPD。它似乎并不能改善非慢性阻塞性肺病症状和合并症的检测。
One of the aims of the COPD Assessment Test (CAT) is to aid communication between the physician and patient about the burden of chronic obstructive pulmonary disease (COPD) on the patient's life. To investigate the impact of the CAT on the quality of primary care consultations in COPD patients. Primary care physicians across Europe conducted six consultations with standardised COPD patients (played by trained actors). Physicians were randomised to see the patient with the completed CAT (CAT+ arm) or without (no CAT arm) during the consultation. These were videoed and independent assessors scored the physicians on their ability to identify and address patient-specific issues such as depression (sub-score A); review standard COPD issues such as breathlessness (sub-score B); their understanding of the case (understanding score); and their overall performance. The primary endpoint was the global score (sub-scores A+B; scale range 0–40). A total of 165 physicians enrolled in the study and carried out six consultations each; 882 consultations were deemed suitable for analysis. No difference was seen between the arms in the global score (no CAT arm 20.3; CAT+ arm 20.7; 95% CI −1.0 to 1.8; p=0.606) or on sub-score A (p=0.255). A statistically significant difference, though of limited clinical relevance, was observed in mean sub-score B (no CAT arm 8.8; CAT+ arm 9.6; 95% CI 0.0 to 1.6; p=0.045). There was no difference in understanding score (p=0.824) or overall performance (p=0.655). The CAT is a disease-specific instrument that aids physician assessment of COPD. It does not appear to improve detection of non-COPD symptoms and co-morbidities.
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影响因子：
3.5
作者：
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通讯作者：
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作者：
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