New Standards for the Bruce Treadmill Protocol in Children and Adolescents
Bibliographic record
Abstract
We have developed normal standards for the Bruce exercise (EX) protocol since a review of 875 studies in patients with congenital or acquired heart disease showed that only 5.1% achieved the predicted 50th percentile for EX time of the standards reported by Cumming, Everatt, and Hastman (Am. J Cardiol 41:69, 1978). Our data are based on 160 males and 103 females, age 4–18 years who met the following criteria: trivial or no heart disease, maximal effort, maximal EX heart rate (HR) > 180 beats/min, and normal resting and EX ECG without arrhythmia. The ECG was monitored continuously and HR computed from the ECG and the end of each minute of EX. Comparison with the predicted data of Cumming et al. for each age group by stage showed essentially identical submaximal EX heart rates but slightly lower maximal HR (–2%), which averaged 197 beats per minute in males and females. EX times were on average 15% lower than the predicted 50th percentile for most age groups in males and females. We developed regression equations, which predict exercise time from age and body size or age, body size and 2nd stage exercise heart rate. They better reflect the capabilities of untrained, asymptomatic children and adolescents seen in our laboratory in the 1990s than the Canadian data of 1978.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.029 | 0.027 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".