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Interpretation of treatment changes in 6-minute walk distance in patients with COPD
Open accessAbstract
There is uncertainty about the interpretation of changes in the 6-min walk distance (6MWD) in chronic obstructive pulmonary disease (COPD) patients and whether the minimal important difference (MID) for this useful outcome measure exists. Data were used from nine trials enrolling a wide spectrum of COPD patients with 6MWD at baseline and follow-up and used to determine threshold values for important changes in 6MWD using three distribution-based methods. Anchor-based methods to determine a MID were also evaluated. Data were included of 460 COPD patients with a mean±sd forced expiratory volume in one second (FEV 1) of 39.2±14.1% predicted and 6MWD of 361±112 m at baseline. Threshold values for important effects in 6MWD were between 29 and 42 m, respectively, using the empirical rule effect size and the standardised response mean. The threshold value was 35 m (95% confidence interval 30–42 m) based on the standard error of measurement. Correlations of 6MWD with patient-reported anchors were too low to provide meaningful MID estimates. 6-min walk distance should change by ∼35 m for patients with moderate to severe chronic obstructive pulmonary disease in order to represent an important effect. This corresponds to a 10% change of baseline 6-min walk distance. The low correlations of 6-min walk distance with patient-reported anchors question whether a minimal important difference exists for the 6-min walk distance.
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“but only the pilot group surpassed all other estimates for the minimum clinically important difference, 30,31 with a value of 54 m (95% CI 37-71 m).32”
From Cognitive behavioral therapy for management of dyspnea: A pilot study (2015) · cites this paper as [31]
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Metadata
- Authors
- Puhan, M. A., Mador, M. J., Held, U., Goldstein, R., Guyatt, G. H., & Schünemann, H. J.
- Affiliations
- University Hospital Zurich (CH)
- University at Buffalo, State University of New York (US)
- University of Zurich (CH)
- University of Toronto (CA)
- McMaster University (CA)
- Istituti Fisioterapici Ospitalieri (IT)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2008-06-11
- Volume
- 32
- Issue
- 3
- Pages
- 637-643
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2041114293
- Cited by
- 373
- References
- 54
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 11 · 2023: 16 · 2022: 19 · 2021: 19 · 2020: 15 · 2019: 8 · 2018: 14 · 2017: 16 · 2016: 20 · 2015: 30 · 2014: 33 · 2013: 33 · 2012: 37
- FWCI
- 23.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Science Foundation
- European Commission
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (115216, 42192, 3233B0/115216/1)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Keywords
- 6-minute walk distance, chronic obstructive pulmonary disease, minimal important difference, cut-off values, treatment effect interpretation, standardized response mean, effect size, anchor-based methods, distribution-based methods, exercise capacity
- MeSH terms
- Aged, Clinical Trials as Topic, Exercise Test, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Severity of Illness Index, Treatment Outcome, Exercise Tolerance, Pulmonary Disease, Chronic Obstructive
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