Submaximal Exercise Testing in Cardiovascular Rehabilitation Settings (BEST Study)
Bibliographic record
Abstract
Background: This study compared changes in actual versus predicted peak aerobic power (V̇O2peak) following cardiovascular rehabilitation (CR). Maximal cardiopulmonary exercise testing (CPET) results were compared to three submaximal estimation methods (a modified Bruce treadmill, Astrand-Ryhming cycle ergometer, and Chester step tests) and the Duke Activity Status Index (DASI). Methods: Adults with cardiovascular disease who completed a 12-week CR program were assessed at baseline and 12 weeks follow-up. CPET, the DASI and 3 subsequent submaximal exercise tests were performed in a random order. Results: Of the 50 adults (age: 57±11 years) who participated, 46 completed the 12-week CR program and exercise tests. At baseline 69%, 68% and 38% of the treadmill, step and cycle tests were successfully completed, respectively. At follow-up 67%, 80% and 46% of the treadmill, step and cycle tests were successfully completed, respectively. No severe adverse events occurred. Significant improvements in V̇O2peak were observed with CPET (3.6±5.5 mL.kg-1.min-1, p<0.001) and the DASI (2.3±4.2 mL.kg-1.min-1, p<0.001). Bland-Altman plots of the change in V̇O2peak between CPET and the four V̇O2peak estimation methods revealed the following: a proportional bias and heteroscedastic 95% limits of agreement (95% LoA) for the submaximal treadmill test, and for the cycle test, step test and DASI, mean bias’ and 95% LoA of 1.0 mL.kg-1.min-1 (21.3, -19.3), 1.4 mL.kg-1.min-1 (15.0, -12.3) and 1.0 mL.kg-1.min-1 (13.8, -11.8), respectively. Conclusion: Given the greater number of successful tests, no serious adverse events and acceptable mean bias, the step test appears to be a valid and safe method for assessing mean changes in V̇O2peak among patients in CR. The DASI also appears to be a valid and practical questionnaire. Wide limits of agreement, however, limit their use to predict individual-level changes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".