Respiratory General Practice Strong — GOLD 2023 / Jones 2009

COPD Assessment Test (CAT)

8-item patient-reported outcome measure quantifying COPD symptom impact on daily life. Validated for GOLD ABCD grouping.

Used in: COPD

Cough*

0 = I never cough, 5 = I cough all the time

Phlegm (sputum)*

0 = No phlegm at all, 5 = Chest completely full of phlegm

Chest tightness*

0 = No tightness at all, 5 = Very tight

Breathlessness walking uphill or 1 flight of stairs*

0 = Not breathless, 5 = Very breathless

Activity limitation at home*

0 = Not limited at all, 5 = Very limited

Confidence leaving home despite lung condition*

0 = Confident, 5 = Not at all confident

Sleep quality*

0 = Good sleep, 5 = Very poor sleep

Energy level*

0 = Lots of energy, 5 = No energy at all

Score interpretation

Low Impact 0–9

CAT 0–9: Low COPD impact on daily life. GOLD low symptom group (A or E-low).

→ Optimise SABA/SAMA for PRN use. Encourage exercise. Annual review. Smoking cessation support.

Medium Impact 10–20

CAT 10–20: Medium impact. GOLD high symptom group (B or E-high). Dual bronchodilator indicated.

→ LAMA + LABA. Pulmonary rehabilitation referral. Vaccination (influenza, pneumococcal, COVID, RSV). Self-management plan. Consider ICS if blood eosinophils ≥ 300 + exacerbation history.

High Impact 21–30

CAT 21–30: High COPD impact. Significant disability.

→ Triple therapy (LAMA + LABA + ICS) if eosinophils ≥ 100 + exacerbations. Pulmonary rehabilitation urgent. LTOT assessment if SpO₂ ≤ 88% at rest. Consider palliative input for severe disease. Social services referral.

Very High Impact 31–40

CAT 31–40: Very high COPD impact. Severely compromised quality of life.

→ Full GOLD Group E management. Urgent respiratory review. Consider referral for lung volume reduction or transplant assessment. Early palliative care integration. Advance care planning.

Interpretation bands for the CAT Score. Apply clinical judgement and local guidance.

References

Jones PW et al. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009.
GOLD 2023 Global Strategy for Prevention, Diagnosis and Management of COPD.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

Related