3-minute constant-rate shuttle walking (3MWT) and stair stepping tests (3MST) to assess exertional breathlessness in COPD: responsiveness to pulmonary rehabilitation and estimation of the minimal important difference
Bibliographic record
Abstract
Rationale: To improve COPD patient care, field-based tests that permit measurement of breathlessness (and its response to therapy) at a standardized level of exertion are needed. This study 1) assessed the responsiveness of the 3MWT and 3MST to detect relief of exertional breathlessness in adults with COPD after a pulmonary rehabilitation (PR) program; and 2) estimated the minimal important difference (MID) in exertional breathlessness for both tests. Methods: 48 adults with COPD and a mean±SD FEV1 of 58±23 %predicted rated their breathlessness intensity using Borg’s 0-10 scale at the end of the 3MWT and 3MST before and after an 8-12 wk PR program. Results: The PR-induced change (Δ) in breathlessness ratings was -0.3±1.6 (p=0.23) and -0.2±1.9 Borg units (p=0.39) for the 3MST and 3MWT, respectively. When the analyses were restricted to participants whose baseline breathlessness ratings were ≥3 Borg units, the Δ in breathlessness ratings was -0.6±1.5 (p=0.04) and -0.8±1.8 Borg units (p=0.02) for the 3MST (n=40) and 3MWT (n=45), respectively. Using a distribution-based approach (0.5*SD of the D in breathlessness ratings), a Δ breathlessness intensity of 0.8 and 0.9 Borg units was estimated as the MID for the 3MST and 3MWT, respectively. Conclusions: 1) The 3MST and 3MWT are responsive to detect relief of exertional breathlessness after PR in COPD, provided breathlessness intensity ratings are ≥3 Borg units at baseline; and 2) a change in breathlessness intensity ratings of 0.8-0.9 Borg units at the end of the 3MST and 3MWT is likely clinically meaningful in COPD.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".