• Samuel Gluck, Matthew J Summers, Thomas P Goddard, Alice Andrawos, Natalie C Smith, Kylie Lange, Theodore J Iwashyna, and Adam M Deane.
• 1Intensive Care Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, Australia. 2Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA, Australia. 3National Health and Medical Research Council of Australia Centre for Research Excellence in Translating Nutritional Science to Good Health, Adelaide, SA, Australia. 4Department of Internal Medicine, University of Michigan Health System, University of Michigan, Ann Arbor, MI. 5Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, MI. 6Intensive Care Unit, The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia. 7Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia.
• Crit. Care Med. 2017 Oct 1; 45 (10): e1036-e1042.

ObjectivesSurrogate-decision maker and patient self-reported estimates of the distances walked prior to acute illness are subjective and may be imprecise. It may be possible to extract objective data from a patient's smartphone, specifically, step and global position system data, to quantify physical activity. The objectives were to 1) assess the agreement between surrogate-decision maker and patient self-reported estimates of distance and time walked prior to resting and daily step-count and 2) determine the feasibility of extracting premorbid physical activity (step and global position system) data from critically ill patients.DesignProspective cohort study.SettingQuaternary ICU.PatientsFifty consecutively admitted adult patients who owned a smartphone, who were ambulatory at baseline, and who remained in ICU for more than 48 hours participated.Measurments And Main ResultsThere was no agreement between patients and surrogates for all premorbid walking metrics (mean bias 108% [99% lower to 8,700% higher], 83% [97% to 2,100%], and 71% [96% to 1,080%], for distance, time, and steps, respectively). Step and/or global position system data were successfully extracted from 24 of 50 phones (48%; 95% CI, 35-62%). Surrogate-decision makers, but not patient self-reported, estimates of steps taken per day correlated with smartphone data (surrogates: n = 13, ρ = 0.56, p < 0.05; patients: n = 13, ρ = 0.30, p = 0.317).ConclusionThere was a lack of agreement between surrogate-decision maker and patient self-reported subjective estimates of distance walked. Obtaining premorbid physical activity data from the current-generation smartphones was feasible in approximately 50% of patients.

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