Measuring Daily Compliance With Physical Activity Tracking in Ambulatory Surgery Patients: Comparative Analysis of Five Compliance Criteria.
Measuring Daily Compliance With Physical Activity Tracking in Ambulatory Surgery Patients: Comparative Analysis of Five Compliance Criteria.
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DOI：
10.2196/22846
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发表时间：
2021-01-26
影响因子：
5
通讯作者：
Pearce O
中科院分区：
文献类型：
--
作者：
Kelly R;Jones S;Price B;Katz D;McCormick C;Pearce O
像Fitbit这样的身体活动跟踪器可以让临床医生监测患者手术后的恢复情况。分析活动跟踪器数据时的一个重要问题是使用适当的标准来确定佩戴的有效日期，以确定患者对佩戴其指定设备的每日依从性。然而，目前尚不清楚不同的标准如何影响从门诊手术中恢复的患者报告的依从性。调查此问题可以通过揭示可能影响合规性计算的因素来帮助通知活动数据的使用。本研究旨在了解使用不同标准如何影响门诊手术患者对活动跟踪的依从性。它还旨在调查解释不同依从性标准结果之间差异的因素。共有62名计划接受全膝关节置换术（TKA，即膝关节置换术）的患者自愿在8周的围手术期内佩戴市售Fitbit Zip活动跟踪器。患者被要求每天佩戴Fitbit Zip，从手术前2周开始，到手术后6周结束。在参加这项研究的62名患者中，有20名提供了Fitbit数据并成功接受了手术。使用5种不同的每日合规性标准分析Fitbit数据，如果患者一天中记录>0步、一天中记录>500步、在10个不同的时间内记录至少一步，则认为他们符合每日跟踪。一天中，在3个不同的时间窗口中记录>0步，或在4个六小时时间窗口中的3个中记录>0步。根据每位患者的依从性结果对标准进行比较。使用热图和线图探索数据。线性混合模型用于确定导致整个样本的依从性结果之间的变化的因素。当应用于患者数据时，5个依从性标准产生不同的结果，最宽松和最严格标准之间报告的依从性平均差异为24%。然而，每例患者报告的依从性受不同标准影响的程度并不一致。有些人相对不受影响，而其他人的变化高达72%。将活动跟踪器作为夹式设备佩戴，而不是佩戴在手腕上，与个体水平上的依从性结果之间的差异更大相关（P=.004，r=.616）。在手术后的前2周，这种效果具有统计学显著性（P<.001）。在手术后的前2周，年龄对依从性也有一个小但显著的主要影响（P= 0.040）。性别和BMI与个体依从性结果的差异无关。最后，分析显示，手术对患者的依从性有影响，手术后活动明显减少。这些减少通过在严格的标准下丢弃更大量的数据来影响合规性计算。本研究表明，不同的依从性标准不能互换使用，以分析TKA患者提供的活动数据。手术导致患者的活动性暂时降低，这影响了他们在使用严格阈值时报告的依从性。活动性降低表明，使用宽松的依从性标准，如>0步或窗口方法，可以避免围手术期不必要的数据排除。鼓励患者在手腕上佩戴设备可以通过增加患者佩戴跟踪器的可能性并确保在手术后2周内记录活动来提高数据质量。ClinicalTrials.gov NCT03518866; https://clinicaltrials.gov/ct2/show/NCT03518866
Physical activity trackers such as the Fitbit can allow clinicians to monitor the recovery of their patients following surgery. An important issue when analyzing activity tracker data is to determine patients’ daily compliance with wearing their assigned device, using an appropriate criterion to determine a valid day of wear. However, it is currently unclear as to how different criteria can affect the reported compliance of patients recovering from ambulatory surgery. Investigating this issue can help to inform the use of activity data by revealing factors that may impact compliance calculations. This study aimed to understand how using different criteria can affect the reported compliance with activity tracking in ambulatory surgery patients. It also aimed to investigate factors that explain variation between the outcomes of different compliance criteria. A total of 62 patients who were scheduled to undergo total knee arthroplasty (TKA, ie, knee replacement) volunteered to wear a commercial Fitbit Zip activity tracker over an 8-week perioperative period. Patients were asked to wear the Fitbit Zip daily, beginning 2 weeks prior to their surgery and ending 6 weeks after surgery. Of the 62 patients who enrolled in the study, 20 provided Fitbit data and underwent successful surgery. The Fitbit data were analyzed using 5 different daily compliance criteria, which consider patients as compliant with daily tracking if they either register >0 steps in a day, register >500 steps in a day, register at least one step in 10 different hours of the day, register >0 steps in 3 distinct time windows, or register >0 steps in 3 out of 4 six-hour time windows. The criteria were compared in terms of compliance outcomes produced for each patient. Data were explored using heatmaps and line graphs. Linear mixed models were used to identify factors that lead to variation between compliance outcomes across the sample. The 5 compliance criteria produce different outcomes when applied to the patients’ data, with an average 24% difference in reported compliance between the most lenient and strictest criteria. However, the extent to which each patient’s reported compliance was impacted by different criteria was not uniform. Some individuals were relatively unaffected, whereas others varied by up to 72%. Wearing the activity tracker as a clip-on device, rather than on the wrist, was associated with greater differences between compliance outcomes at the individual level (P=.004, r=.616). This effect was statistically significant (P<.001) in the first 2 weeks after surgery. There was also a small but significant main effect of age on compliance in the first 2 weeks after surgery (P=.040). Gender and BMI were not associated with differences in individual compliance outcomes. Finally, the analysis revealed that surgery has an impact on patients’ compliance, with noticeable reductions in activity following surgery. These reductions affect compliance calculations by discarding greater amounts of data under strict criteria. This study suggests that different compliance criteria cannot be used interchangeably to analyze activity data provided by TKA patients. Surgery leads to a temporary reduction in patients’ mobility, which affects their reported compliance when strict thresholds are used. Reductions in mobility suggest that the use of lenient compliance criteria, such as >0 steps or windowed approaches, can avoid unnecessary data exclusion over the perioperative period. Encouraging patients to wear the device at their wrist may improve data quality by increasing the likelihood of patients wearing their tracker and ensuring that activity is registered in the 2 weeks after surgery. ClinicalTrials.gov NCT03518866; https://clinicaltrials.gov/ct2/show/NCT03518866
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影响因子：
5
作者：
Hermsen, Sander;Moons, Jonas;De Groot, Martijn
通讯作者：
De Groot, Martijn
影响因子：
5
作者：
Alinia, Parastoo;Cain, Chris;Ghasemzadeh, Hassan
通讯作者：
Ghasemzadeh, Hassan
影响因子：
3.1
作者：
Sirard, John R.;Slater, Megan E.
通讯作者：
Slater, Megan E.
影响因子：
4
作者：
Boyer, Katherine A.;Kiratli, B. Jenny;Beaupre, Gary S.
通讯作者：
Beaupre, Gary S.
DOI：
10.1186/s12966-015-0314-1
发表时间：
2015-12-18
期刊：
The international journal of behavioral nutrition and physical activity
影响因子：
--
作者：
Evenson KR;Goto MM;Furberg RD
通讯作者：
Furberg RD