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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. 

Luiz Alberto Forgiarini Júnior, Universidade La Salle, Physiotherapy Course and Postgraduate Program in Health and Human Development, Canoas, RS – Brazil.

orcid_id14.png https://orcid.org/0000-0002-6706-2703

Ricardo Kenji Nawa, Hospital Israelita Albert Einstein

orcid_id14.png https://orcid.org/0000-0002-0852-7013

Marcio Luiz Ferreira De Camillis, Hospital Moinhos de Vento

orcid_id14.png 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,

orcid_id14.png https://orcid.org/0000-0002-7195-6400

Fernanda 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.

orcid_id14.pnghttps://orcid.org/0000-0002-7195-6400

Eder Chaves Pacheco, Universidade Vale dos Sinos, Porto Alegre, RS – Brazil.

orcid_id14.png 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.

orcid_id14.pnghttps://orcid.org/0000-0001-7367-854X

Leonardo Miguel Corrêa Garcia, Hospital Moinhos de Vento, Porto Alegre, RS – Brazil.

orcid_id14.png https://orcid.org/0000-0002-5730-3147

Karina Tavares Timenetsky, Hospital Israelita Albert Einstein, São Paulo, SP – Brazil.

orcid_id14.png https://orcid.org/0000-0002-4176-2445

Forgiarini Júnior, L. A., Nawa, R. K., De Camillis, M. L. F., Buttignol, M., Kutchak, F. M., Pacheco, E. C., Gonçalves, L. H. R., Garcia, L. M. C., & Timenetsky, K. T. (2023). Clinimetric properties of the Perme Intensive Care Unit Mobility Score: A multicenter study for minimum important difference and responsiveness analysis. Colombia Medica, 54(3), e2005580. https://doi.org/10.25100/cm.v54i3.5580 (Original work published September 25, 2023)

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Received 2023-04-04
Accepted 2023-09-21
Published 2023-12-14