دورية أكاديمية

Biological quality control for cardiopulmonary exercise testing in multicenter clinical trials

التفاصيل البيبلوغرافية
العنوان: Biological quality control for cardiopulmonary exercise testing in multicenter clinical trials
المؤلفون: Porszasz, Janos, Blonshine, Susan, Cao, Robert, Paden, Heather, Casaburi, Richard, Rossiter, Harry
بيانات النشر: BioMed Central Ltd.
سنة النشر: 2016
المجموعة: BioMed Central
مصطلحات موضوعية: Calibration, Treadmill test, Pulmonary gas exchange, Z-score, Precision and accuracy
الوصف: Background Precision and accuracy assurance in cardiopulmonary exercise testing (CPET) facilitates multicenter clinical trials by maximizing statistical power and minimizing participant risk. Current guidelines recommend quality control that is largely based on precision at individual testing centers (minimizing test–retest variability). The aim of this study was to establish a multicenter biological quality control (BioQC) method that considers both precision and accuracy in CPET. Methods BioQC testing was 6-min treadmill walking at 20 W and 70 W (below the lactate threshold) with healthy non-smoking laboratory staff (15 centers; ~16 months). Measurements were made twice within the initial 4 weeks and quarterly thereafter. Quality control was based on: 1) within-center precision (coefficient of variation [CV] for oxygen uptake [V̇O 2 ], carbon dioxide output [V̇CO 2 ], and minute ventilation [V̇E] within ±10 %); and 2) a criterion that V̇O 2 at 20 W and 70 W, and ∆V̇O 2 /∆WR were each within ±10 % predicted. “Failed” BioQC tests (i.e., those outside the predetermined criterion) prompted troubleshooting and repeated measurements. An additional retrospective analysis, using a composite z-score combining both BioQC precision and accuracy of V̇O 2 at 70 W and ∆V̇O 2 /∆WR, was compared with the other methods. Results Of 129 tests (5 to 8 per center), 98 (76 %) were accepted by within-center precision alone. Within-center CV was <9 %, but between-center CV remained high (9.6 to 12.5 %). Only 43 (33 %) tests had all V̇O 2 measurements within the ±10 % predicted criterion. However, a composite z-score of 0.67 identified 67 (52 %) non-normal outlying tests, exclusion of which coincided with the minimum CV for CPET variables. Conclusions Study-wide BioQC using a composite z-score can increase study-wide precision and accuracy, and optimize the design and conduct of multicenter clinical trials involving CPET. Trial registration ClinicalTrials.gov identifier: NCT01072396 ; February 19, 2010.
نوع الوثيقة: article in journal/newspaper
اللغة: English
العلاقة: http://www.biomedcentral.com/1471-2466/16/13Test
الإتاحة: http://www.biomedcentral.com/1471-2466/16/13Test
حقوق: Copyright 2016 Porszasz et al.
رقم الانضمام: edsbas.E66953DD
قاعدة البيانات: BASE