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目的:6 min步行距离(6MWD)是临床上常见的功能性运动能力测试,特别是对于慢性呼吸系统疾病患者。一些文献记载了关于白种人的6MWD的最小临床重要差异(MCID),但对亚洲人群的相关信息未见记载。本研究旨在建立亚洲成人慢性呼吸道疾病患者6MWD的最小临床重要差异。方法:采用“锚定”法和“分布”法对新加坡中央医院肺康复计划登记处的资料进行了分析。“锚定”法收集确诊为慢性呼吸道疾病的患者50例,其中男38例,女12例;平均年龄(64.2±12.3)岁,通过电话采访及使用整体变化评估量表(GROC)评价患者肺康复计划后的自觉改善程度,再将患者在肺康复计划中6MWD的改变数值与相对应的患者自觉改善程度进行比较,这种关系用操作特征曲线(ROC)统计表示。通过“分布”法确定6MWD的MCID,从门诊和住院的肺康复计划(PRP)参与者中检索医疗记录136例,其中男103例,女33例;平均年龄(60.1±14.1)岁。结果 :ROC曲线表明6MWD出现临床显著性变化的最佳临界值为17.4 m,其对应的敏感性为79.4%,特异性为81.3%,阳性似然比为4.23。由“分布”法确定6MWD的最小临床重要差异值为18.6 m。结论:18.6 m为新加坡华人6MWD的最小临床重要差异的估计值。
Objective: 6 min walking distance (6 MWD) is a common clinical functional motor function test, especially in patients with chronic respiratory diseases. Some documents record the minimal clinically significant difference (MCID) for Caucasians in 6MWD, but no information is available on the Asian population. This study aimed to establish the minimum clinically important difference in 6MWD among adults with chronic respiratory diseases in Asia. METHODS: The data of the Registry of Lung Rehabilitation Program at Singapore General Hospital were analyzed using the “Anchoring” and “Distribution” methods. Fifty patients with chronic respiratory diseases were diagnosed by “anchored” method, including 38 males and 12 females, with an average age of (64.2 ± 12.3) years. The interviews were conducted by telephone and using the overall change assessment scale (GROC) Patient’s voluntary rehabilitation after pulmonary rehabilitation program, and then patients in the pulmonary rehabilitation program 6MWD changes in the value of patients with the corresponding self-improvement compared to the degree of this relationship using the operating characteristic curve (ROC) statistics. The MCID of 6 MWD was determined by the “distribution” method and 136 medical records were retrieved from outpatient and inpatient Pulmonary Rehabilitation Program (PRP) participants, including 103 males and 33 females, with an average age of 60.1 ± 14.1 years. Results: The ROC curve showed that the optimal cutoff value of 6MWD clinically significant change was 17.4 m with a corresponding sensitivity of 79.4%, a specificity of 81.3% and a positive likelihood ratio of 4.23. The minimum clinically important difference for 6MWD was 18.6 m determined by the “distribution” method. Conclusion: 18.6 m is an estimate of the smallest clinically significant difference in Chinese 6MWD in Singapore.