Minimal Clinically Important Difference of Average Daily Steps Measured Through a Consumer Smartwatch in People With Mild-to-Moderate Parkinson Disease: Cross-Sectional Study
Bibliographic record
Abstract
Background: Recent studies demonstrated the validity, reliability, and accuracy of consumer smartwatches for measuring daily steps in people with Parkinson disease (PD). However, no study to date has estimated the minimal clinically important difference (MCID) for average daily steps (avDS), measured through a consumer smartwatch in people with PD. Objective: This study aimed to calculate the MCID of avDS, measured through a commercial smartwatch (Garmin Vivosmart 4) in people with PD. Methods: People with PD with a disease stage <4, without cognitive impairment, and who were able to walk unaided, wore a Garmin Vivosmart 4 smartwatch for 5 consecutive days on the wrist least affected by the disease, allowing the computation of avDS. To define the 3 levels of MCID for avDS, we used an anchor-based method linked to: (1) scales capturing subtle changes in global mobility and motor functions, (2) clinical and health-related measures, and (3) disease-related patient-reported outcomes. Linear regressions, Student t test, and ANOVA were used to estimate the minimal change in avDS based on anchors relevant change. For each level, the overall MCID was calculated as the average of the variables included, and the range was reported. Results: A total of 100 people with PD were enrolled. Participants took on average 5949 (SD 3034) daily steps, ranging from 357 to 12,620. The MCID of avDS anchored to standardized measures of motor symptoms and mobility was 581 steps/day (range 554-608) or around 10% of mean avDS in our population. The MCID of avDS anchored to clinical and health-related variables was 1200 steps/day (range 350-1683), or around 20% of mean avDS in our population. Finally, the MCID of avDS anchored to disease-related patient-reported outcomes was 1592 steps/day (range 594-2589), or around 27% of the mean avDS in our population. Conclusions: These findings could be relevant for designing future clinical trials involving avDS as a digital mobility outcome in daily life for people with PD and evaluating the effectiveness of the intervention promoting free-living walking in this population.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| 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".