@Article{info:doi/10.2196/22846，作者=“Kelly, Ryan and Jones, Simon and Price, Blaine and Katz, Dmitri and McCormick, Ciaran and Pearce, Oliver”，标题=“测量门诊手术患者每日身体活动跟踪依从性:五种依从性标准的比较分析”，期刊=“JMIR Mhealth Uhealth”，年=“2021”，月=“1”，日=“26”，卷=“9”，数=“1”，页=“e22846”，关键词=“活动跟踪;依从性;合规;手术;背景:像Fitbit这样的身体活动追踪器可以让临床医生监测患者手术后的恢复情况。在分析活动跟踪器数据时，一个重要的问题是确定患者每天佩戴其指定设备的依从性，使用适当的标准来确定佩戴的有效日期。然而，目前尚不清楚不同的标准如何影响门诊手术后康复患者的依从性。调查这个问题可以通过揭示可能影响合规性计算的因素来帮助了解活动数据的使用情况。目的:本研究旨在了解使用不同的标准如何影响门诊手术患者对活动跟踪的依从性。它还旨在调查解释不同依从性标准的结果之间差异的因素。 Methods: A total of 62 patients who were scheduled to undergo total knee arthroplasty (TKA, ie, knee replacement) volunteered to wear a commercial Fitbit Zip activity tracker over an 8-week perioperative period. Patients were asked to wear the Fitbit Zip daily, beginning 2 weeks prior to their surgery and ending 6 weeks after surgery. Of the 62 patients who enrolled in the study, 20 provided Fitbit data and underwent successful surgery. The Fitbit data were analyzed using 5 different daily compliance criteria, which consider patients as compliant with daily tracking if they either register >0 steps in a day, register >500 steps in a day, register at least one step in 10 different hours of the day, register >0 steps in 3 distinct time windows, or register >0 steps in 3 out of 4 six-hour time windows. The criteria were compared in terms of compliance outcomes produced for each patient. Data were explored using heatmaps and line graphs. Linear mixed models were used to identify factors that lead to variation between compliance outcomes across the sample. Results: The 5 compliance criteria produce different outcomes when applied to the patients' data, with an average 24{\%} difference in reported compliance between the most lenient and strictest criteria. However, the extent to which each patient's reported compliance was impacted by different criteria was not uniform. Some individuals were relatively unaffected, whereas others varied by up to 72{\%}. Wearing the activity tracker as a clip-on device, rather than on the wrist, was associated with greater differences between compliance outcomes at the individual level (P=.004, r=.616). This effect was statistically significant (P<.001) in the first 2 weeks after surgery. There was also a small but significant main effect of age on compliance in the first 2 weeks after surgery (P=.040). Gender and BMI were not associated with differences in individual compliance outcomes. Finally, the analysis revealed that surgery has an impact on patients' compliance, with noticeable reductions in activity following surgery. These reductions affect compliance calculations by discarding greater amounts of data under strict criteria. Conclusions: This study suggests that different compliance criteria cannot be used interchangeably to analyze activity data provided by TKA patients. Surgery leads to a temporary reduction in patients' mobility, which affects their reported compliance when strict thresholds are used. Reductions in mobility suggest that the use of lenient compliance criteria, such as >0 steps or windowed approaches, can avoid unnecessary data exclusion over the perioperative period. Encouraging patients to wear the device at their wrist may improve data quality by increasing the likelihood of patients wearing their tracker and ensuring that activity is registered in the 2 weeks after surgery. Trial Registration: ClinicalTrials.gov NCT03518866; https://clinicaltrials.gov/ct2/show/NCT03518866 ", issn="2291-5222", doi="10.2196/22846", url="http://mhealth.www.mybigtv.com/2021/1/e22846/", url="https://doi.org/10.2196/22846", url="http://www.ncbi.nlm.nih.gov/pubmed/33496677" }