The minimal important difference of real-world digital mobility outcomes in COPD

Résumé fourni par la source

Background: The European Mobilise-D project developed 24 digital mobility outcomes (DMOs) that measure walking activity (e.g., number of steps, number of walking bouts (WB), walking duration) and gait (e.g., walking speed, cadence). Aim To provide evidence on the DMOs' minimal important difference (MID) in people with COPD. Methods: 551 people with COPD from 7 European sites were recruited. Assessments at baseline and 12-month follow-up included a 7-day mobility measurement with a single wearable device. Based on the natural course of COPD, we expected worsening outcomes over time. To assess MID, we related changes in DMOs over time to changes in anchors (i.e., pre-defined outcomes related to mobility that have an established MID, and a global impression of change question). If correlations fulfilled predefined criteria, we used linear models and receiver operating curves to calculate the MIDs. Several experts triangulated individual MID estimates from DMOs that had sufficient estimates to single values. Results: 363 participants (36.5% females, mean age 65.5 (SD 9.5) years) who had DMO and outcome data at both time points were included. For 6 out of the 24 DMOs, sufficient evidence was available and MIDs could be triangulated: Walking duration: 0.8 h/day; number of steps: 600 steps/day; number of WB/day: 20; number of WB>10s: 15; number of WB>30s: 3; number of WB>60s:1. Conclusion: This study provides a first indication of how to interpret the magnitude of changes in DMOs. The fact that correlations were too low to assess MIDs for gait DMOs might highlight the importance of activity DMOs in people with COPD. Future data from intervention studies will further establish the DMOs' MID.

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