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Type: Journal article
Title: Wide disagreement between alternative assessments of premorbid physical activity: subjective patient and surrogate reports and objective smartphone data
Author: Gluck, S.
Summers, M.
Goddard, T.
Andrawos, A.
Smith, N.
Lange, K.
Iwashyna, T.
Deane, A.
Citation: Critical Care Medicine, 2017; 45(10):1036-1042
Publisher: Lippincott Williams & Wilkins
Issue Date: 2017
ISSN: 0090-3493
Statement of
Samuel Gluck, Matthew J. Summers, Thomas P. Goddard, Alice Andrawos, Natalie C. Smith, Kylie Lange, Theodore J. Iwashyna, Adam M. Deane
Abstract: Objectives: Surrogate-decision maker and patient self-reported estimates of the distances walked prior to acute illness are subjective and may be imprecise. It may be possible to extract objective data from a patient’s smartphone, specifically, step and global position system data, to quantify physical activity. The objectives were to 1) assess the agreement between surrogate-decision maker and patient self-reported estimates of distance and time walked prior to resting and daily step-count and 2) determine the feasibility of extracting premorbid physical activity (step and global position system) data from critically ill patients. Design: Prospective cohort study. Setting: Quaternary ICU. Patients: Fifty consecutively admitted adult patients who owned a smartphone, who were ambulatory at baseline, and who remained in ICU for more than 48 hours participated. Measurments and Main Results: There was no agreement between patients and surrogates for all premorbid walking metrics (mean bias 108% [99% lower to 8,700% higher], 83% [97% to 2,100%], and 71% [96% to 1,080%], for distance, time, and steps, respectively). Step and/or global position system data were successfully extracted from 24 of 50 phones (48%; 95% CI, 35– 62%). Surrogate-decision makers, but not patient self-reported, estimates of steps taken per day correlated with smartphone data (surrogates: n = 13, ρ = 0.56, p < 0.05; patients: n = 13, ρ = 0.30, p = 0.317). Conclusion: There was a lack of agreement between surrogatedecision maker and patient self-reported subjective estimates of distance walked. Obtaining premorbid physical activity data from the current-generation smartphones was feasible in approximately 50% of patients.
Keywords: Critical illness; exercise tolerance; physical activity; smartphone; technology
Rights: © 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
DOI: 10.1097/CCM.0000000000002599
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