Clinimetric properties of the Perme Intensive Care Unit Mobility Score A multicenter study for minimum important difference and responsiveness analysis
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Background:
The use of instruments in clinical practice with measurement properties tested is highly recommended, in order to provide adequate assessment and measurement of outcomes.
Objective:
To calculate the minimum clinically important difference (MCID) and responsiveness of the Perme Intensive Care Unit Mobility Score (Perme Score).
Methods:
This retrospective, multicentric study investigated the clinimetric properties of MCID, estimated by constructing the Receiver Operating Characteristic (ROC). Maximizing sensitivity and specificity by Youden's, the ROC curve calibration was performed by the
Hosmer and Lemeshow goodness-of-fit test. Additionally, we established the responsiveness, floor and ceiling effects, internal consistency, and predictive validity of the Perme Score.
Results:
A total of 1.200 adult patient records from four mixed general intensive care units (ICUs) were included. To analyze which difference clinically reflects a relevant evolution we calculated the area under the curve (AUC) of 0.96 (95% CI: 0.95-0.98), and the optimal cut-off value of 7.0 points was established. No substantial floor (8.8%) or ceiling effects (4.9%) were observed at ICU discharge. However, a moderate floor effect was observed at ICU admission (19.3%), in contrast to a very low incidence of ceiling effect (0.6%). The Perme Score at ICU admission was associated with hospital mortality, OR 0.86 (95% CI: 0.82-0.91), and the predictive
validity for ICU stay presented a mean ratio of 0.97 (95% CI: 0.96-0.98).
Conclusions:
Our findings support the establishment of the minimum clinically important difference and responsiveness of the Perme Score as a measure of mobility status in the ICU.
- Intensive Care Unit
- outcome measures
- clinimetric properties
- rehabilitation
- Outcome Assessment
- Health Care
- ROC Curve
- Calibration
Ricardo Kenji Nawa, Hospital Israelita Albert Einstein
https://orcid.org/0000-0002-0852-7013
Marcio Luiz Ferreira De Camillis, Hospital Moinhos de Vento
https://orcid.org/0000-0001-5566-6422
Monique Buttignol, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil, - Hospital Municipal da Vila Santa Catarina Dr. Gilson de Cássia Marques de Carvalho;São Paulo, SP, Brazil,
https://orcid.org/0000-0002-7195-6400Fernanda Machado Kutchak, Universidade Vale dos Sinos, Porto Alegre, RS – Brazil. Hospital Nossa Senhora da Conceição – Grupo Hospitalar Conceição, Porto Alegre, RS – Brazil.
Universidade Vale dos Sinos, Porto Alegre, RS – Brazil.
Hospital Nossa Senhora da Conceição – Grupo Hospitalar Conceição, Porto Alegre, RS – Brazil.
Eder Chaves Pacheco, Universidade Vale dos Sinos, Porto Alegre, RS – Brazil.
https://orcid.org/0000-0001-7367-854X
Louise Helena Rodrigues Gonçalves, Hospital Municipal da Vila Santa Catarina Dr. Gilson de Cássia Marques de Carvalho; Hospital Israelita Albert Einstein, São Paulo, SP – Brazil.
Leonardo Miguel Corrêa Garcia, Hospital Moinhos de Vento, Porto Alegre, RS – Brazil.
https://orcid.org/0000-0002-5730-3147
Karina Tavares Timenetsky, Hospital Israelita Albert Einstein, São Paulo, SP – Brazil.
https://orcid.org/0000-0002-4176-2445
Luiz Alberto Forgiarini Júnior, Universidade La Salle, Physiotherapy Course and Postgraduate Program in Health and Human Development, Canoas, RS – Brazil.
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