{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:07:31Z","timestamp":1788930451331,"version":"build-2803163510"},"reference-count":40,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca"},{"id":[{"id":"https:\/\/ror.org\/05qqrnb63","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Adv. Respir. Med.","ARM"],"abstract":"<jats:p>Although short-term CAT score variability has been associated with COPD exacerbations, evidence supporting its integration into virtual assistant-based monitoring remains limited. The aim of this study was to assess the short-term variability in CAT scores using a virtual management tool in patients with COPD and to examine its relationship with the prediction of exacerbations. A prospective observational single-center study was conducted in patients aged &gt;35 with COPD and an exacerbator phenotype (\u22652 outpatient exacerbations or \u22651 hospitalization in the previous year). Follow-up was performed weekly, including the CAT questionnaire, through calls were conducted by the virtual assistant Tucuvi Health Manager\u00ae during a period of one year. A total of 106 patients were included; 64.2% were male, with a mean (SD) age of 66.8 (7.9) years and a median FEV1(%) of 38.8 (30.1\u201345.0). The mean follow-up was 25 weeks [IQR 20\u201335], during which 73 (69%) patients experienced \u22651 exacerbation, accounting for 192 episodes (26% of which required hospitalization). A total of 2550 CAT scores were collected. The mean baseline CAT score was 17.9 (7.6), and scores increased significantly during exacerbations compared with non-exacerbation periods and according to exacerbation severity. Each one-point increase in absolute CAT score was associated with an 11.1% increase in the odds of exacerbation (OR: 1.11; 95% CI: 1.08\u20131.13), while a weekly variation of \u22652 points (MCID) was associated with more than sixfold higher odds (OR: 6.30; 95% CI: 4.28\u20139.27). The optimal cut-off for CAT change in the prediction of exacerbation risk was 3 points with a ROC curve of 0.773. Weekly deterioration in CAT scores was associated with increased exacerbation risk in patients with COPD. Short-term increases in CAT may serve as clinically useful warning signals for exacerbation.<\/jats:p>","DOI":"10.3390\/arm94050064","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:12:25Z","timestamp":1788783145000},"page":"64","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COPD Assessment Test Variability as a Predictor of Exacerbations in Patients with COPD: A Prospective Study Using Virtual Assistant Monitoring"],"prefix":"10.3390","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6151-4174","authenticated-orcid":false,"given":"Cristina","family":"Aljama","sequence":"first","affiliation":[{"name":"Pneumology Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Institut de Recerca (VHIR), Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, 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