Last Updated on May 9, 2022
COPD Assessment
Modified MRC Dyspnoea scale
- mMRC Grade 0: I only get breathless with strenuous exercise
- mMRC Grade 1: I get short of breath when hurrying on the level/ walking up a slight hill
- mMRC Grade 2: I walk slower than people of the same age on the level because of breathlessness // I have to stop for breath when walking on my own pace on the level
- mMRC Grade 3: I stop for breath after walking about 100 meters or after a few minutes on the level
- mMRC Grade 4: I am too breathless to leave the house or I am breathless when dressing or undressing
COPD Assessment Test (CAT)
Each item below has scale 0 – scale 5
- I never cough —> I cough all the time
- I have no phlegm in my chest at all —> My chest is full of phlegm
- My chest does not fell tight at all —> My chest feels very tight
- When I walk up a hill or one flight of stairs I am not breathless —> When I walk up a hill or one flight of stairs I am very breathless
- I am not limited doing any activities at home —> I am very limited doing activities at home
- I am confident leaving my home despite my lung condition —> I am not at all confident leaving my home because of my lung condition
- I sleep soundly —> I don’t sleep soundly because of my lung condition
- I have lots of energy —> I have no energy at all
GOLD Grade
| Grade | FEV1 (% predicted) |
| GOLD 1 | ≥ 80 |
| GOLD 2 | 50 – 79 |
| GOLD 3 | 30 – 49 |
| GOLD 4 | < 30 |
ABCD groups
GOLD Group | Moderate or Severe Exacerbation History | mMRC or CAT |
A | 0 or 1 (not leading to hospital admission) | • mMRC 0 - 1, OR • CAT <10 |
B | 0 or 1 (not leading to hospital admission) | • mMRC ≥2, OR • CAT ≥10 |
C | • ≥2 moderate / severe exacerbation, or | • mMRC 0 - 1, OR • CAT <10 |
D | • ≥2 moderate / severe exacerbation, or | • mMRC ≥2, OR • CAT ≥10 |
Classification of COPD patient
Examples:
• ‘GOLD Grade 4, Group D‘: FEV1 < 30% of predicted + CAT score 15 + 1 exacerbation in past year leading to hospital admission
• ‘GOLD Grade 4, Group B‘: FEV1 < 30% of predicted + CAT score 15 + 0 exacerbation in past year leading to hospital admission
Key Point during Presentation
• Risk factor(s) of COPD for that patient (e.g. chronic smoker)
• GOLD groups (e.g. ‘GOLD A’, ‘GOLD B’)
• Whether requiring long-term oxygen therapy at home
Further Reading / Reference
- GOLD pocket guide / full report
- CPG Management of Chronic Obstructive Pulmonary Disease (Second Edition) [Full CPG] [Quick Reference]
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