Chronic Obstructive Pulmonary Disease (COPD)

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Last Updated on August 19, 2026

Table of Contents

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 VS mMRC Grade 2 walking on my own pace/ 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 VS mMRC Grade 1, i.e. hurrying on the level 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 • ≥1 exacerbation leading to hospital admission	• mMRC 0 - 1, OR • CAT <10
D	• ≥2 moderate / severe exacerbation, or • ≥1 exacerbation leading to hospital admission	• 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