Global Health Outcomes, Eli Lilly and Company, Indianapolis, IN, USA.
Diabetes Technol Ther. 2012 Dec;14(12):1118-25. doi: 10.1089/dia.2012.0123. Epub 2012 Sep 27.
The Ability to Perform Physical Activities of Daily Living Questionnaire (APPADL) measures the self-reported ability of individuals with type 2 diabetes mellitus (T2DM) and obesity to perform daily physical activities. The primary objective of this study was to estimate APPADL test-retest reliability, responsiveness, and minimal important change (MIC).
Study participants were individuals with T2DM and body mass index ≥30 kg/m(2) enrolled in clinical weight loss programs in the United States. Data were obtained for clinical measures, APPADL, and other patient-reported instruments. APPADL test-retest reliability was estimated with intraclass correlation coefficient. To estimate responsiveness in a subgroup of participants, baseline and 6-month data were analyzed using paired t test and calculation of responsiveness indices (e.g., effect size [ES]). To estimate MIC, both distribution-based and anchor-based methods were used.
Test-retest data for 106 study participants (mean age, 52 years; 69% female; 31% white; mean body mass index, 38 kg/m(2)) yielded an intraclass correlation coefficient of 0.91. In the subgroup (n = 40) used to estimate responsiveness, weight was significantly less at end point than at baseline (mean, 222.0 vs. 231.9 pounds; P < 0.001, ES = 0.24), and APPADL scores were significantly better than at baseline (mean, 77.0 vs. 70.8; P = 0.01, ES = 0.32). Results of distribution- and anchor-based methods to establish MIC suggest values of 6-14 points (0-100 scale).
The APPADL has demonstrated reliability and validity. In addition, it has demonstrated responsiveness to weight loss in individuals with T2DM and obesity, thereby making it a potentially valuable tool in the evaluation of weight loss interventions (e.g., antihyperglycemic medications that produce weight loss) targeted toward patients with T2DM.
日常生活活动能力问卷（APPADL）衡量了 2 型糖尿病（T2DM）和肥胖患者进行日常体力活动的自我报告能力。本研究的主要目的是评估 APPADL 的测试-重测信度、反应度和最小临床重要变化（MIC）。
本研究对象为美国参加临床减重项目的 T2DM 患者，体重指数（BMI）≥30kg/m²。研究收集了临床指标、APPADL 及其他患者报告的工具的数据。采用组内相关系数评估 APPADL 的测试-重测信度。为了在亚组患者中评估反应度，对基线和 6 个月的数据进行了配对 t 检验和反应度指标（如效应量[ES]）的计算。MIC 则采用基于分布和基于锚定的方法进行评估。
106 例研究对象（平均年龄 52 岁，69%为女性，31%为白人，平均 BMI 为 38kg/m²）的测试-重测数据得出组内相关系数为 0.91。在用于评估反应度的亚组（n=40）中，终点时的体重显著低于基线（平均，222.0 磅比 231.9 磅；P＜0.001，ES=0.24），APPADL 评分也显著优于基线（平均，77.0 分比 70.8 分；P=0.01，ES=0.32）。基于分布和基于锚定的 MIC 评估方法的结果提示，MIC 值在 6-14 分（0-100 分）之间。
APPADL 具有可靠的信度和效度，此外，它还能反映 2 型糖尿病和肥胖患者体重减轻的情况，因此它可能成为评估以 T2DM 患者为目标人群的减重干预（如能减轻体重的降糖药物）的一种有价值的工具。
