ArticleThorax2021
Validity and responsiveness of the Daily- and Clinical visit-PROactive Physical Activity in COPD (D-PPAC and C-PPAC) instruments.
Article in Thorax, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Investigating the prognostic value of digital mobility outcomes in patients with chronic obstructive pulmonary disease: a systematic literature review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Physical activity measurements in individuals with interstitial lung disease: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Listening to the patients' voice: a conceptual framework of the walking experience.Age and ageing · 2023Pooled it
- A Long-Term Physical Activity Coaching Program for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.American journal of respiratory and critical care medicine · 2025Trial
- Communication About Sexuality (COSY) Encourages Physical Activity in COPD: A Randomised Trial.International journal of chronic obstructive pulmonary disease · 2025Trial
- Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery.BMJ open respiratory research · 2024Trial
- Lung volume reduction surgeryThe European respiratory journal · 2023Trial
- Trial
- The construct validity of real-world digital mobility outcomes in people with COPD.ERJ open research · 2026Article
- Influence of basal physical activity and air quality on a walking programme in patients with COPD.BMJ open respiratory research · 2026Observational
- Pulmonary Obstruction and Age, Not Activity, Associate With Muscle Oxidative Impairment in Smokers With and Without COPD.Journal of cachexia, sarcopenia and muscle · 2026Observational
- How do people with COPD walk? A European study on digitally measured real-world gait.The European respiratory journal · 2025Article
- Implementing sensor-based digital health technologies in clinical trials: Key considerations from the eCOA Consortium.Clinical and translational science · 2024Review
- Real-world walking cadence in people with COPD.ERJ open research · 2024Article
- Use of Ecological Momentary Assessment to Measure Dyspnea in COPD.International journal of chronic obstructive pulmonary disease · 2024Article
- Measuring What Is Meaningful in Cancer Cachexia Clinical Trials: A Path Forward With Digital Measures of Real-World Physical Behavior.JCO clinical cancer informatics · 2023Review
- From Meaningful Outcomes to Meaningful Change Thresholds: A Path to Progress for Establishing Digital Endpoints.Therapeutic innovation & regulatory science · 2023Article
- Cultural adaptation and validation of the Brazilian Portuguese version of the PROactive Physical Activity in COPD-clinical visit instrument for individuals with COPD.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2023Article
- A cross-sectional survey on the effects of ambient temperature and humidity on health outcomes in individuals with chronic respiratory disease.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2023Article
- The impact of endoscopic lung volume reduction on physical activity coaching in patients with severe emphysema.ERJ open research · 2022Article
Corrections and comments
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Authors and funding
20 authors at 15 institutions in 15 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Daily-PROactive and Clinical visit-PROactive Physical Activity (D-PPAC and C-PPAC) instruments in chronic obstructive pulmonary disease (COPD) combines questionnaire with activity monitor data to measure patients' experience of physical activity. Their amount, difficulty and total scores range from 0 (worst) to 100 (best) but require further psychometric evaluation.
objectiveTo test reliability, validity and responsiveness, and to define minimal important difference (MID), of the D-PPAC and C-PPAC instruments, in a large population of patients with stable COPD from diverse severities, settings and countries.
methodsWe used data from seven randomised controlled trials to evaluate D-PPAC and C-PPAC internal consistency and construct validity by sex, age groups, COPD severity, country and language as well as responsiveness to interventions, ability to detect change and MID.
resultsWe included 1324 patients (mean (SD) age 66 (8) years, forced expiratory volume in 1 s 55 (17)% predicted). Scores covered almost the full range from 0 to 100, showed strong internal consistency after stratification and correlated as a priori hypothesised with dyspnoea, health-related quality of life and exercise capacity. Difficulty scores improved after pharmacological treatment and pulmonary rehabilitation, while amount scores improved after behavioural physical activity interventions. All scores were responsive to changes in self-reported physical activity experience (both worsening and improvement) and to the occurrence of COPD exacerbations during follow-up. The MID was estimated to 6 for amount and difficulty scores and 4 for total score.
conclusionsThe D-PPAC and C-PPAC instruments are reliable and valid across diverse COPD populations and responsive to pharmacological and non-pharmacological interventions and changes in clinically relevant variables.
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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.