Minimal clinically important difference of 3-minute chair rise test and the DIRECT questionnaire after pulmonary rehabilitation in COPD patients
Bibliographic record
Abstract
Jonathan Lévesque,1 Anestis Antoniadis,2 Pei Zhi Li,3 Frédéric Herengt,4 Christophe Brosson,5 Jean-Marie Grosbois,6 Alain Bernady,7 Anthony Bender,8,9 Murielle Favre,10 Antoine Guerder,11 Pascale Surpas,12 Thomas Similowski,11,13 Bernard Aguilaniu141Department of Medicine, Pneumology Service, Hôpital Maisonneuve-Rosemont, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; 2Laboratoire Jean Kuntzmann UMR5224, Statistics Department, Université Grenoble-Alpes, Grenoble, France; 3Montreal Chest Institute, McGill University Health Center Research Institute, McGill University, Montreal, Quebec, Canada; 4Centre de Réadaptation Cardio-Respiratoire-Dieulefit Santé, Dieulefit, France; 5Private Physiotherapist, Cours Liberation, Grenoble, France; 6Pneumology Service, Centre Hospitalier de Béthune, Béthune, France; 7Toki-Eder Centre Médical Cardio-Respiratoire, Cambo-les-Bains, France; 8Private Physiotherapist, Boulevard de Metz Mont-Saint-Martin, France; 9LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg; 10Centre de Pneumologie Henri Bazire, Saint-Julien-de-Ratz, France; 11AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie, Médecine Intensive et Réanimation, Département R3S, Paris, France; 12Centre Médical de Bayère, Charnay, France; 13Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France; 14Faculty of Medicine, Université Grenoble-Alpes, Grenoble, FranceBackground: The 3-minute chair rise test (3-minute CRT) and the Disability Related to COPD Tool (DIRECT) are two reproducible and valid short tests that can assess the benefit of pulmonary rehabilitation (PR) in terms of functional capacity and dyspnea in everyday activities.Methods: We determined the minimal clinically important difference (MCID) of the DIRECT questionnaire and 3-minute CRT using distribution methods and anchor encroaches with a panel of eight standard tests in a cohort of 116 COPD patients who completed a PR program in real-life settings.Results: The estimated MCID for the 3-minute CRT and DIRECT scores was five repetitions and two units, respectively, using separate and combined independent anchors. The all-patient (body mass index-obstruction-dyspnea-exercise [BODE] scores 0–7), BODE 0–2 (n=42), and BODE 3–4 (n=50) groups showed improvements greater than the MCID in most tests and questionnaires used. In contrast, the BODE 5–7 group (n=24) showed improvements greater than MCID in only the 3-minute CRT, 6-minute walk test, endurance exercise test, and DIRECT questionnaire.Discussion and conclusion: This study demonstrates that the short and simple DIRECT questionnaire and 3-minute CRT are responsive to capture the beneficial effects of a PR program in COPD patients, including those with severe disease.Trial registration number: NCT03286660. Keywords: MCID, chair tests, tools, COPD, pulmonary rehabilitation, outcomes assessment
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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 | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 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".