PMID- 17136974
OWN - NLM
STAT- MEDLINE
DCOM- 20070222
LR  - 20191110
IS  - 1541-2555 (Print)
IS  - 1541-2563 (Linking)
VI  - 2
IP  - 1
DP  - 2005 Mar
TI  - Maximum exercise as an outcome in COPD: minimal clinically important difference.
PG  - 137-41
AB  - Limitation of physical activity occupies a central role in the symptom complex of 
      patients with chronic obstructive pulmonary disease (COPD), and improvement in 
      exercise capacity is a key outcome of response to COPD therapy. Maximum exercise 
      capacity testing facilitates assessment of physiologic mechanisms of exercise and 
      allows quantitation of the degree of limitation. This manuscript utilizes 
      published data from the National Emphysema Treatment Trial to investigate the 
      minimal clinically important difference (MCID) in maximum exercise capacity in 
      patients with severe emphysema. Distribution- and opinion-based methods were used 
      to estimate MCID. Expert clinician opinion yielded a value of 10 Watts as the 
      MCID for change in maximum exercise capacity. Baseline standard deviation and 
      error data yielded a one-half standard deviation-based estimate of 10.5 Watts and 
      a standard error-based estimate of 4.2 Watts. In subjects randomized to medical 
      therapy, the mean (+/-SD) 24-month change in maximum exercise capacity following 
      medical therapy was -9.2 +/- 1.2 Watts, whereas among those randomized to lung 
      volume reduction surgery, mean 24-month change in maximum exercise capacity was 
      1.7 +/- 17.7 Watts, with a mean difference between the groups of 10.9 Watts. The 
      observed difference in maximum exercise capacity after 24 months between subjects 
      randomized to medical versus surgical therapy conforms to both opinion- and 
      distribution-based estimates of MCID. Further investigation is needed to develop 
      and validate estimates of MCID for maximum exercise capacity and other key 
      clinical outcomes in COPD.
FAU - Sutherland, E Rand
AU  - Sutherland ER
AD  - Department of Medicine, National Jewish Medical and Research Center and 
      University of Colorado School of Medicine, 1400 Jackson St., J217, Denver, 
      Colorado 80206, USA. sutherlande@njc.org
FAU - Make, Barry J
AU  - Make BJ
LA  - eng
GR  - K23 HL04385/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - England
TA  - COPD
JT  - COPD
JID - 101211769
SB  - IM
MH  - Aged
MH  - Data Interpretation, Statistical
MH  - Emphysema/*physiopathology/*surgery
MH  - *Exercise Tolerance
MH  - Female
MH  - Humans
MH  - Male
MH  - Multicenter Studies as Topic
MH  - Pulmonary Disease, Chronic Obstructive/*physiopathology/*therapy
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
EDAT- 2006/12/02 09:00
MHDA- 2007/02/23 09:00
CRDT- 2006/12/02 09:00
PHST- 2006/12/02 09:00 [pubmed]
PHST- 2007/02/23 09:00 [medline]
PHST- 2006/12/02 09:00 [entrez]
AID - 10.1081/copd-200051358 [doi]
PST - ppublish
SO  - COPD. 2005 Mar;2(1):137-41. doi: 10.1081/copd-200051358.