Turan Hamdiye, Yasacı Zeynal, Elkan Hasan
Harran University, Sanliurfa, Turkey.
Inonu University, Malatya, Turkey.
Obes Surg. 2025 Mar;35(3):860-866. doi: 10.1007/s11695-025-07714-x. Epub 2025 Jan 31.
Obesity is a global health issue that complicates surgical outcomes, particularly in bariatric/metabolic surgery candidates. Assessing functional capacity is critical for optimizing preoperative planning and postoperative care. The Duke Activity Status Index (DASI) is a simple, self-administered questionnaire that estimates functional capacity based on daily activities. This study evaluates the reliability and clinical applicability of the DASI as an alternative to the 6-min walk test (6-MWT) for bariatric/metabolic surgery individuals living with obesity.
This cross-sectional study included 126 individuals who are candidates for bariatric/metabolic surgery. Participants completed the DASI and 6-MWT. Test-retest reliability was assessed using intraclass correlation coefficients (ICCs), and validity was evaluated through correlations with 6-MWT results. The agreement was measured using the standard error of measurement (SEM) and minimal detectable change (MDC).
The DASI demonstrated excellent internal consistency (Cronbach's alpha = 0.86) and test-retest reliability (ICC = 0.97, 95% CI: 0.96-0.98). A strong correlation was observed between DASI and 6-MWT scores (r = 0.603; p < 0.001). ROC analysis showed an optimal cut-off score of 24.1 (AUC = 0.836), with 72.2% sensitivity and 74.1% specificity. The SEM and MDC values were 2.36 and 6.54 points, respectively.
The DASI is a reliable, accessible tool for bariatric surgeons to assess functional capacity in candidates for bariatric/metabolic surgery. Its simplicity, strong correlation with performance-based measures, and minimal resource requirements make it ideal for preoperative evaluations, particularly in resource-limited settings.
肥胖是一个全球性的健康问题，会使手术结果复杂化，尤其是在减肥/代谢手术的候选者中。评估功能能力对于优化术前规划和术后护理至关重要。杜克活动状态指数（DASI）是一种简单的自我管理问卷，可根据日常活动估算功能能力。本研究评估了DASI作为肥胖症患者减肥/代谢手术个体6分钟步行试验（6-MWT）替代方法的可靠性和临床适用性。
这项横断面研究纳入了126名减肥/代谢手术候选者。参与者完成了DASI和6-MWT。使用组内相关系数（ICC）评估重测信度，并通过与6-MWT结果的相关性评估效度。使用测量标准误差（SEM）和最小可检测变化（MDC）来衡量一致性。
DASI表现出出色的内部一致性（Cronbach's α = 0.86）和重测信度（ICC = 0.97，95% CI：0.96 - 0.98）。观察到DASI和6-MWT评分之间存在强相关性（r = 0.603；p < 0.001）。ROC分析显示最佳截断分数为24.1（AUC = 0.836），灵敏度为72.2%，特异度为74.1%。SEM和MDC值分别为2.36和6.54分。
DASI是减肥外科医生评估减肥/代谢手术候选者功能能力的可靠且易于使用的工具。其简单性、与基于表现的测量方法的强相关性以及最低资源需求使其成为术前评估的理想选择，特别是在资源有限的环境中。
