Clinically Meaningful Change Estimates for the Six‐Minute Walk Test and Daily Activity in Individuals With Chronic Heart Failure
Clinically Meaningful Change Estimates for the Six‐Minute Walk Test and Daily Activity in Individuals With Chronic Heart Failure
复制标题
慢性心力衰竭患者六分钟步行测试和日常活动的临床意义变化估计
DOI：
10.1097/01823246-201324030-00004
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
M. Dickinson
中科院分区：
文献类型：
--
作者：
M. Shoemaker;A. Curtis;E. Vangsnes;M. Dickinson
目的：本初步研究的目的是提供慢性心力衰竭（CHF）门诊患者6分钟步行试验（6 MWT）和每日活动的最小可检测差异（MDD）和最小临床重要差异（MCID）的初步估计。研究方法：22名患有稳定的纽约心脏协会功能II级和III级CHF的成人的便利样本进行了两次基线6 MWT，间隔30分钟休息。然后，受试者佩戴三轴加速计7天，以监测日常活动。在7周的常规护理后，受试者再次佩戴加速计7天，然后返回诊所完成关于其心脏病的总体变化评级量表（GRS），并进行另一组6 MWT。对于6 MWT，使用两个基线6 MWT距离计算MDD。对于日常活动，使用两种方法计算MDD：（1）基线监测期间的日间重测可靠性，和（2）报告GRS无变化的受试者的基线至随访重测可靠性。对于报告GRS“改善”的受试者，使用平均值和95%置信区间（CI 95%）计算6 MWT和每日活动的MCID。结果：6 MWT CI 95%时的MDD为32.4米。6 MWT的MCID为30.1（CI 95% 20.8，39.4）米。每日活动的MDD为5，909矢量幅度单位（VMU·hr. -1），每日活动的MCID为1，337 VMU·hr. -1，6 MWT的MDD和MCID具有良好的一致性，表明具有临床意义的变化约为32米。然而，计算的MCID远小于MDD表示的测量误差，表明该样本中的MCID被低估，或者日常活动可能对总体疾病状态的变化具有鲁棒性。
Purpose: The purpose of the present pilot study was to provide a preliminary estimate of the minimum detectable difference (MDD) and minimum clinically important difference (MCID) of the six‐minute walk test (6MWT) and daily activity in outpatients with chronic heart failure (CHF). Methods: A convenience sample of 22 adults with stable New York Heart Association Functional Class II and III CHF performed two baseline 6MWTs separated by 30 minutes of rest. Subjects then wore a triaxial accelerometer for 7 days to monitor daily activity. After 7 weeks of usual care, subjects again wore the accelerometer for 7 days and then returned to the clinic to complete the Global Rating of Change Scale (GRS) with regard to their heart disease and perform another set of 6MWTs. For the 6MWT, the MDD was calculated using the two baseline 6MWT distances. For daily activity, the MDD was calculated using two methods: (1) day‐to‐day test‐retest reliability during baseline monitoring, and (2) baseline to follow‐up test‐retest reliability in those who reported no change on the GRS. The MCID for the 6MWT and daily activity was calculated using the mean and 95% confidence interval (CI95%) for those subjects who reported ‘improvement’ on the GRS. Results: The MDD at the CI95% for the 6MWT was 32.4 meters. The MCID for the 6MWT was 30.1 (CI95% 20.8, 39.4) meters. The MDD for daily activity was 5,909 vector magnitude units (VMU·hr.‐1) The MCID for daily activity was 1,337 VMU·hr.‐1 There was good alignment of the MDD and MCID for the 6MWT, suggesting that clinically meaningful change is approximately 32 meters. However, the calculated MCID was substantially less than measurement error as represented by the MDD, indicating that the MCID was underestimated in this sample or that daily activity may be robust to change in overall disease status.
DOI：
--
发表时间：
2001-02
期刊：
The Journal of rheumatology
影响因子：
--
作者：
D. Beaton;C. Bombardier;J. Katz;J. Wright;George A. Wells;M. Boers;V. Strand;B. Shea
通讯作者：
D. Beaton;C. Bombardier;J. Katz;J. Wright;George A. Wells;M. Boers;V. Strand;B. Shea
通过 6 分钟步行测试预测左心室功能障碍患者的死亡率和发病率。
DOI：
--
发表时间：
1993
期刊：
JAMA : the journal of the American Medical Association
影响因子：
--
作者：
Bittner,V;Weiner,DH;Yusuf,S;Rogers,WJ;McIntyre,KM;Bangdiwala,SI;Kronenberg,MW;Kostis,JB;Kohn,RM;Guillotte,M
通讯作者：
Guillotte,M