Coute Ryan A, Ehrenfeld Jesse M, Gupta Deepak K, Terekhov Maxim A, Wanderer Jonathan P
Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN; Kansas City University of Medicine and Biosciences, Kansas City, MO.
Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN; Department of Biomedical Informatics, Vanderbilt University, Nashville, TN; Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN; Department of Health Care Policy, Vanderbilt University, Nashville, TN.
Am Heart J. 2017 Jun;188:82-86. doi: 10.1016/j.ahj.2017.03.005. Epub 2017 Mar 14.
Electronic screening tools, such as Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short-Form 12a (PF-SF12a), may aid in the assessment of functional capacity. However, PROMIS PF-SF12a has not been validated against exercise capacity, or compared with established questionnaires, including the Duke Activity Status Index (DASI). We compared the DASI and PROMIS PF-SF12a to the maximum metabolic equivalents (METs) achieved during exercise stress testing.
DASI and PROMIS PF-SF12a were electronically administered to 100 adult patients (median age 56years, 61% male) immediately before exercise stress testing. DASI-predicted METs and PROMIS T score were calculated. Correlations with exercise METs with and without age adjustment were examined. Linear regression lines were derived and adjusted r statistic was calculated. We compared models with the Davidson-Mackinnon J test.
The median (interquartile range) DASI-predicted METs, PROMIS Tscore, and exercise METs were 8.97 (7.61-9.89), 47.90 (43.33-52.40), and 10.10 (10.10-12.80), respectively. In unadjusted correlation analyses, PROMIS accounted for 26% of the variance in exercise METs compared with 38% with DASI. With age adjustment, the rvalues increased to 0.36 (PROMIS) and 0.46 (DASI). In both unadjusted and age-adjusted analyses, inclusion of DASI improved prediction of exercise METs beyond PROMIS T score (P<.0001). In contrast, PROMIS T score did not improve exercise MET prediction compared with DASI alone (P>.10).
Among patients undergoing clinically indicated exercise stress testing, DASI outperformed PROMIS PF-SF12a as a predictor of exercise METs.
电子筛查工具，如患者报告结局测量信息系统（PROMIS）身体功能简表12a（PF-SF12a），可能有助于评估功能能力。然而，PROMIS PF-SF12a尚未针对运动能力进行验证，也未与包括杜克活动状态指数（DASI）在内的既定问卷进行比较。我们将DASI和PROMIS PF-SF12a与运动负荷测试期间达到的最大代谢当量（METs）进行了比较。
在运动负荷测试前，对100名成年患者（中位年龄56岁，61%为男性）进行电子方式的DASI和PROMIS PF-SF12a评估。计算DASI预测的METs和PROMIS T分数。检查了有无年龄调整时与运动METs的相关性。得出线性回归线并计算调整后的r统计量。我们用戴维森-麦金农J检验比较模型。
DASI预测的METs、PROMIS T分数和运动METs的中位数（四分位间距）分别为8.97（7.61 - 9.89）、47.90（43.33 - 52.40）和10.10（10.10 - 12.80）。在未调整的相关性分析中，PROMIS占运动METs方差的26%，而DASI为38%。进行年龄调整后，r值分别增至0.36（PROMIS）和0.46（DASI）。在未调整和年龄调整分析中，纳入DASI均能改善对运动METs的预测，超过PROMIS T分数（P<0.0001）。相比之下，与单独使用DASI相比，PROMIS T分数并未改善对运动METs的预测（P>0.10）。
在接受临床指示的运动负荷测试的患者中，作为运动METs的预测指标，DASI的表现优于PROMIS PF-SF12a。
