ArticleThe American journal of medicine2015
Improved reclassification of mortality risk by assessment of physical activity in patients referred for exercise testing.
Article in The American journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Temporal Trends in the Cardiorespiratory Fitness of 2,525,827 Adults Between 1967 and 2016: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2019Pooled it
- Association of Physical Activity Levels with Severe Multimorbidity Among Middle-Aged and Older Adults: Evidence from CHARLS and a Community Sample.Healthcare (Basel, Switzerland) · 2026Article
- The acceptability of a novel seismocardiography device for measuring VOBMC public health · 2025Article
- Article
- Cardiorespiratory Fitness and Incidence of Digestive System Cancers in Men.Journal of gastrointestinal cancer · 2024Article
- Validity and reliability of seismocardiography for the estimation of cardiorespiratory fitness.Cardiovascular digital health journal · 2023Article
- Nonexercise machine learning models for maximal oxygen uptake prediction in national population surveys.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Cardiorespiratory Fitness and Its Place in Medicine.Reviews in cardiovascular medicine · 2023Review
- Cardiorespiratory Fitness in the Prevention and Management of Cardiovascular Disease.Reviews in cardiovascular medicine · 2022Review
- Association Between Change in Nonexercise Estimated Cardiorespiratory Fitness and Mortality in Men.Mayo Clinic proceedings. Innovations, quality & outcomes · 2022Article
- Non-exercise estimated cardiorespiratory fitness and mortality from all-causes, cardiovascular disease, and cancer in the NIH-AARP diet and health study.European journal of preventive cardiology · 2022Article
- Adding Estimated Cardiorespiratory Fitness to the Framingham Risk Score and Mortality Risk in a Korean Population-Based Cohort Study.International journal of environmental research and public health · 2022Article
- Physical Activity and Cardiorespiratory Fitness: Vital Signs for Cardiovascular Risk Assessment.Current cardiology reports · 2021Review
- Validity of Cardiorespiratory Fitness Measured with Fitbit Compared to V˙O2max.Medicine and science in sports and exercise · 2019Article
- Cardiorespiratory fitness and cancer in women: A prospective pilot study.Journal of sport and health science · 2019Article
- [Optical coherence tomography angiography as a future diagnostic tool in sports medicine?]Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2019Review
- Truth About Physical Fitness and Risk of Acute Myocardial Infarction: The HUNT Is On.Journal of the American Heart Association · 2019Article
- Exercise Testing in Sports Medicine.Deutsches Arzteblatt international · 2018Review
- Predictors of Achieving Recommended Daily Physical Activity Among Anesthesiologists at a Large Tertiary Care Academic Center.Journal of clinical medicine research · 2018Article
- Towards ageing well: Use it or lose it: Exercise, epigenetics and cognition.Biogerontology · 2017Article
Corrections and comments
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Authors and funding
6 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundInability to meet minimal guidelines on physical activity is associated with poor health outcomes, but quantifying activity can be complex. We studied whether a simple question regarding participation in regular activity improves risk classification for all-cause mortality.
methodsMaximal exercise testing was performed in 6962 patients (mean age, 58.9 ± 11 years) for clinical reasons. Subjects also were assessed for participation in regular activity using a simple yes/no response to meeting minimal recommendations on activity. The incremental value of adding a simple physical activity assessment to clinical, demographic, and exercise test information to predict mortality was determined using Cox proportional hazards models, net reclassification improvement, and integrated discrimination index during a mean follow-up of 9.7 ± 4 years.
resultsSubjects who did not meet the minimal guidelines on activity had a lower exercise capacity (7.4 ± 4.3 vs 9.1 ± 3.6 metabolic equivalents, P < .0001) and a higher annual mortality rate (2.42% vs 1.71%, P < .001). Not meeting activity guidelines was associated with an age-adjusted 36% higher risk of mortality (hazard ratio, 1.36; 95% confidence interval, 1.22-1.51, P < .0001). Among clinical and exercise test variables, fitness had the highest C-index for predicting mortality (0.72, P < .001). The addition of physical activity classification to a model including traditional risk factors resulted in a net reclassification improvement of 22.8% (P < .001); adding fitness to the traditional risk factor model resulted in a net reclassification improvement of 43.5% (P < .001).
conclusionsThe addition of a simple assessment of physical activity status significantly improves reclassification of risk for all-cause mortality among patients who are referred for exercise testing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.