Chronic Airways Assessment Test: Psychometric properties in patients with asthma and/or COPD

Erin L. Tomaszewski* (Corresponding Author), Mark J. Atkinson, Christer Janson, Niklas Karlsson, Barry Make, David Price, Helen K. Reddel, NOVELTY study investigators, NOVELTY Scientific Community

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Background: No short patient-reported outcome (PRO) instruments assess overall health status across different obstructive lung diseases. Thus, the wording of the introduction to the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) was modified to permit use in asthma and/or COPD. This tool is called the Chronic Airways Assessment Test (CAAT).
Methods: The psychometric properties of the CAAT were evaluated using baseline data from the NOVELTY study (NCT02760329) in patients with physician-assigned asthma, asthma+COPD or COPD. Analyses included exploratory/confirmatory factor analyses, differential item functioning and
analysis of construct validity. Responses to the CAAT and CAT were compared in patients with asthma+COPD and those with COPD.
Results: CAAT items were internally consistent (Cronbach’s alpha: >0.7) within each diagnostic group (n=510). Models for structural and measurement invariance were strong. Tests of differential item functioning showed small differences between asthma and COPD in individual items, but these were not consistent in direction and had minimal overall impact on the total score. The CAAT and CAT were highly consistent when assessed in all NOVELTY patients who completed both (N=277, Pearson’s correlation coefficient: 0.90). Like the CAT itself, CAAT scores correlated moderately (0.4– 0.7) to strongly (>0.7) with other PRO measures and weakly (Conclusions: CAAT scores appear to reflect the same health impairment across asthma and COPD, making the CAAT an appropriate PRO instrument for patients with asthma and/or COPD. Its brevity makes it suitable for use in clinical studies and routine clinical practice.
Original languageEnglish
Article number106
Number of pages13
JournalRespiratory Research
Early online date8 Apr 2023
Publication statusPublished - 8 Apr 2023

Bibliographical note

The authors would like to thank the patients who participated in this study and wish to acknowledge the work of the NOVELTY Scientific Community and the NOVELTY study investigators, who are listed in full below, and Sharon MacLachlan (Evidera, London, UK), who participated in the analysis of sections of the data. Medical writing support, under the direction of the authors, was provided by Niall Tyrer, MBiolSci, CMC Connect, a division of IPG Health Medical Communications, funded by AstraZeneca, Cambridge, UK, in accordance with Good Publication Practice (GPP 2022) guidelines (Ann Intern Med 2022; 175(9):1298–1304).
The NOVELTY study was funded by AstraZeneca.


  • Asthma
  • COPD
  • patient-reported
  • psychometrics
  • chronic airways assessment test
  • COPD assessment test


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