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Acta Medica Medianae
Vol. 54, No 1, March, 2015

UDC 61
ISSN 0365-4478(Printed version)
ISSN 1821-2794(Online)



Review article                                                                                         UDC: 616.24-008.4-06-07


 Validity of CAT and mMRC – dyspnea score in
evaluation of COPD severity

 Nena Milačić1, Bojan Milačić2, Olivera Dunjić3, Maja Milojković3


Clinic of Internal Medicine, Department of Pulmonology, Clinical Center of Montenegro, Podgorica, Montenegro1

Clinical Center of Montenegro, Center for Thoracic Surgery, Podgorica, Montenegro2

University of Niš, Faculty of Medicine,  Institute of Pathophysiology, Serbia3

Contact: Nena Milačić
Generala Pavla Jurišića Šturma 3/4, 18000 Niš, Serbia


Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality worldwide. Although predominantly denoted as a pulmonary disease, COPD also presents with various extra-pulmonary effects which influence different aspects of patients’ physical, emotional and mental well-being. Traditionally, evaluation of COPD severity is based on determination of pulmonary function and particularly on forced expiratory volume in 1 second (FEV1). However, numerous evidences show that FEV1 is not a parameter of sufficient strength when compared to the value of clinical symptoms, e.g. shortness of breath, cough, and COPD patients’ quality of life (QoL). Besides, many clinical manifestations of COPD (anxiety, depression and decreased physical ability) are best expressed by patients themselves, and can be better determined by appropriate questionnaires. Some of currently recommended questionnaires used worldwide are CAT (COPD assessment test) and modified Medical Research Council (mMRC) dyspnea score, in combination with FEV1. Global initiative for COPD – GOLD with its current directives from 2013 includes CAT and mMRC parallel with a number of clinical exacerbations and FEV1 as the most valid parameters and based on that, introduces COPD classification into four groups – A,B,C and D, according to the severity of disease. Therefore, we consider that a full insight into the patient’s QoL and treatment efficacy are impossible without introduction of these self-evaluation questionnaires to the classical instrumental respiratory function evaluation in COPD patients. Acta Medica Medianae 2015;54(1): 66-70.


Key words: COPD, CAT score, mMRC-dyspnea scale, GOLD