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Discriminant Validity of a Single Clinical Question for the Screening of Inactivity in Individuals Living with COPD

Authors: Maria Antonia Ramon; Cristóbal Esteban; Francisco Ortega; Pilar Cebollero; Inés Carrascosa; Cristina Martinez-González; Patricia Sobradillo; +3 Authors

Discriminant Validity of a Single Clinical Question for the Screening of Inactivity in Individuals Living with COPD

Abstract

Quantifying physical activity in chronic obstructive pulmonary disease (COPD) with questionnaires and activity monitors in clinical practice is challenging. The aim of the present study was to analyse the discriminant validity of a single clinical question for the screening of inactive individuals living with COPD.A multicentre study was carried out in stable COPD individuals both in primary and tertiary care. Patients wore the Dynaport accelerometer for 8 days and then answered 5 physical activity questions developed for the study, referring to the week in which their physical activity was monitored. Receiver operating characteristic (ROC) curve analysis with physical activity level (PAL) as the gold standard reference was used to determine the best cut-off point for each of the 5 clinical physical activity questions tested.A total of 86 COPD participants were analysed (males 68.6%; mean (SD) age 66.6 (8.5) years; FEV1 50.9 (17.3)% predicted; mean of 7305 (3906) steps/day). Forty-two (48.8%) participants were considered physically inactive (PAL ≤1.69). Answers to 4 out of 5 questions significantly differed in active vs inactive patients. The Kappa index and ROC curves showed that the answer to the question "On average, how many minutes per day do you walk briskly?" had the best discriminative capacity for inactivity, with an area under the curve (AUC) (95% Confidence interval (CI)) of 0.73 (0.63-0.84) and 30 min/day was identified as the best cut-off value (sensitivity (95% CI): 0.75 (0.60-0.87); specificity: 0.76 (0.61-0.88)).The present results indicate that self-reported brisk walk time lower than 30 min/day may be a valid tool for the screening of inactivity in individuals living with COPD in routine care, if more detailed physical activity measures are not feasible.

Country
Spain
Keywords

validation studies., ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica, physical activity, Walking, International Journal of Chronic Obstructive Pulmonary Disease, Caminades (Exercici), PHENOMENA AND PROCESSES::Musculoskeletal and Neural Physiological Phenomena::Musculoskeletal Physiological Phenomena::Movement::Locomotion::Walking, FENÓMENOS Y PROCESOS::fenómenos fisiológicos nerviosos y musculoesqueléticos::fenómenos fisiológicos musculoesqueléticos::movimiento::actividad motora::ejercicio físico, chronic obstructive pulmonary disease, Diseases of the respiratory system, Pulmonary Disease, Chronic Obstructive, PHENOMENA AND PROCESSES::Musculoskeletal and Neural Physiological Phenomena::Musculoskeletal Physiological Phenomena::Movement::Motor Activity::Exercise, Humans, outcome assessment, Exercise, validation studies, Original Research, Aged, DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive, FENÓMENOS Y PROCESOS::fenómenos fisiológicos nerviosos y musculoesqueléticos::fenómenos fisiológicos musculoesqueléticos::movimiento::locomoción::caminata, RC705-779, Physical activity, Pulmons - Malalties obstructives, Chronic obstructive pulmonary disease, Outcome assessment, Validation studies

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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