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Record W4282584907 · doi:10.1186/s13054-022-04048-3

The sit-to-stand test as a patient-centered functional outcome for critical care research: a pooled analysis of five international rehabilitation studies

2022· article· en· W4282584907 on OpenAlexafffund
Heather K. O’Grady, Lara Edbrooke, Christopher Farley, Sue Berney, Linda Denehy, Zudin Puthucheary, Michelle E. Kho, Ian Ball, Karen E. A. Burns, France Clarke, Aileen Costigan, Alison Fox‐Robichaud, Ian Gordon, Kimberley Haines, Margaret S. Herridge, Tim Karachi, Vincent Lo, Alexandra MacDonell, Sunita Mathur, Alexander J. Molloy, Dale M. Needham, Amy M. Pastva, Julie C. Reid, Bram Rochwerg, Joleen Rose, Jill Rudkowski, Andrew Seely

Bibliographic record

VenueCritical Care · 2022
Typearticle
Languageen
FieldMedicine
TopicIntensive Care Unit Cognitive Disorders
Canadian institutionsSt. Joseph’s Healthcare HamiltonHamilton Health SciencesJuravinski HospitalMcMaster University
FundersMedical Research CouncilReseau canadien de recherche respiratoirePhysiotherapy Research FoundationIntensive Care FoundationCanadian Institutes of Health ResearchAmerican Thoracic SocietyUniversity of WaterlooIntensive Care SocietyOntario Ministry of Research and InnovationNational Health and Medical Research CouncilJohns Hopkins University
KeywordsMedicineCeiling effectMechanical ventilationPhysical therapyRehabilitationIntensive care unitPsychological interventionEmergency medicineInternal medicine

Abstract

fetched live from OpenAlex

BACKGROUND: With ICU mortality rates decreasing, it is increasingly important to identify interventions to minimize functional impairments and improve outcomes for survivors. Simultaneously, we must identify robust patient-centered functional outcomes for our trials. Our objective was to investigate the clinimetric properties of a progression of three outcome measures, from strength to function. METHODS: Adults (≥ 18 years) enrolled in five international ICU rehabilitation studies. Participants required ICU admission were mechanically ventilated and previously independent. Outcomes included two components of the Physical Function in ICU Test-scored (PFIT-s): knee extensor strength and assistance required to move from sit to stand (STS); the 30-s STS (30 s STS) test was the third outcome. We analyzed survivors at ICU and hospital discharge. We report participant demographics, baseline characteristics, and outcome data using descriptive statistics. Floor effects represented ≥ 15% of participants with minimum score and ceiling effects ≥ 15% with maximum score. We calculated the overall group difference score (hospital discharge score minus ICU discharge) for participants with paired assessments. RESULTS: Of 451 participants, most were male (n = 278, 61.6%) with a median age between 60 and 66 years, a mean APACHE II score between 19 and 24, a median duration of mechanical ventilation between 4 and 8 days, ICU length of stay (LOS) between 7 and 11 days, and hospital LOS between 22 and 31 days. For knee extension, we observed a ceiling effect in 48.5% (160/330) of participants at ICU discharge and in 74.7% (115/154) at hospital discharge; the median [1st, 3rd quartile] PFIT-s difference score (n = 139) was 0 [0,1] (p < 0.05). For STS assistance, we observed a ceiling effect in 45.9% (150/327) at ICU discharge and in 77.5% (79/102) at hospital discharge; the median PFIT-s difference score (n = 87) was 1 [0, 2] (p < 0.05). For 30 s STS, we observed a floor effect in 15.0% (12/80) at ICU discharge but did not observe a floor or ceiling effect at hospital discharge. The median 30 s STS difference score (n = 54) was 3 [1, 6] (p < 0.05). CONCLUSION: Among three progressive outcome measures evaluated in this study, the 30 s STS test appears to have the most favorable clinimetric properties to assess function at ICU and hospital discharge in moderate to severely ill participants.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.081
metaresearch head score (Gemma)0.087
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: Meta-analysis
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.081
Threshold uncertainty score0.426

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0810.087
Meta-epidemiology (narrow)0.0030.001
Meta-epidemiology (broad)0.0110.032
Bibliometrics0.0120.010
Science and technology studies0.0010.001
Scholarly communication0.0050.002
Open science0.0020.003
Research integrity0.0020.001
Insufficient payload (model declined to judge)0.0020.000

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.

Opus teacher head0.112
GPT teacher head0.454
Teacher spread0.342 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designMeta-analysis
Domainnot available
GenreEmpirical

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".

Quick stats

Citations42
Published2022
Admission routes2
Has abstractyes

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