A 55-year-old patient presents with an mMRC score of 2 and a CAT score of 12. Spirometry readings showed an FEV1 of 70% of predicted and four COPD exacerbations within the past year. When assessing a patient, start with determining his or her symptoms as represented by the CAT and/or mMRC questionnaires. In this example, the patient would be classified as either Group B or D because the questionnaire results correlate with more symptoms. Next, look at the patient's risk by comparing spirometry readings and exacerbation history. When the spirometry results are evaluated, the patient would be described as moderate disease (GOLD 2), which correlates with low risk, or Group B. When the patient's exacerbation history is looked at, he or she would be classified as high risk, or Group D. It is recommended that the highest risk parameter be utilized to yield a more accurate reflection of the patient's current COPD status. Therefore, this patient would be classified as Group D based on the high severity of risk associated with the history of exacerbations.
mMRC: The Modified British Medical Research Council (mMRC) questionnaire is used to determine the health status of a patient by assessing physical limitations due to shortness of breath.
CAT: The COPD Assessment Test (CAT) questionnaire is utilized to assess a patient's quality of life with COPD.
source: http://www.medscape.com/viewarticle/809210_3
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