PPubMed22 Nov 2018Cited 42×

Moving beyond threshold‐based dichotomous classification to improve the accuracy in classifying non‐responders J. T. Bonafiglia <i> et al </i> .

Jacob T. Bonafiglia, Matthew W. Nelms, Nicholas Preobrazenski, Camille LeBlanc, Lauren Robins, Simo Lu, Alexander Lithopoulos, Jeremy J. Walsh, Brendon J. Gurd

Abstract

'Camille LeBlanc' 'Lauren Robins' 'Simo Lu' 'Alexander Lithopoulos' 'Jeremy J. Walsh' 'Brendon J. Gurd'] Title: Abstract We examined maximal oxygen consumption responses following exercise training to demonstrate the limitations associated with threshold-based dichotomous classification of responders and non-responders and proposed alternative methods for classification. Specifically, we: 1) calculated individual probabilities of response, and 2) classified individuals using response confidence intervals (CI) and reference points of zero and a smallest worthwhile change of 0.5 METs. Our findings support the use of individual probabilities and individual CIs to improve the accuracy in non-response classification.

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Using individual probabilities and confidence intervals improves accuracy of classifying non‑responders compared to traditional threshold‑based dichotomous methods.

What’s new

i.Demonstrated limitations of threshold‑based dichotomous classification of non‑responders
ii.Introduced individual probability calculations and confidence‑interval methods for response classification
iii.Applied these methods to VO2max and work‑rate data, showing reduced misclassification rates
iv.Provided guidance for future research on personalized exercise prescription

How they did it

The authors re‑analyzed VO2max data from 29 healthy men who completed a 4‑week cycling program or control. They calculated typical error, individual probabilities of a positive response, and 50% and 90% confidence intervals using a smallest worthwhile change of 0.5 MET. Classifications based on these metrics were compared to traditional 2×TE threshold methods.

What they found

2×TE threshold yielded a 22% non‑response rate (14/63) whereas 90% CI reduced it to 6% (4/63) for zero‑based and 10% (6/63) for SWC‑based thresholds
Uncertain classifications rose to 14% (9/63) with zero‑based and 33% (21/63) with SWC‑based 90% CIs
Typical error CVs: VO2max 2.39% (overall) vs 6.76% using 1‑min tests only; WRPEAK 5.29%
Eight participants were classified as responders for both VO2max and WRPEAK, while six showed discordant classifications

Caveats

✕CI calculations rely on accurate TE estimates and assume random measurement error, which is challenging with small sample sizes
✕Only pre‑ and post‑training measures were used; repeated measures throughout the intervention were not collected
✕The methods characterize response magnitude but do not identify causal mechanisms behind individual differences

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