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Validation of the 6 min walk test according to the OMERACT filter: a systematic literature review by the EPOSS-OMERACT group
  1. Jérôme Avouac1,
  2. Otylia Kowal-Bielecka2,
  3. David Pittrow3,
  4. Doerte Huscher4,
  5. Frank Behrens5,
  6. Christopher P Denton6,
  7. Ivan Foeldvari7,
  8. Marc Humbert8,
  9. Marco Matucci-Cerinic9,
  10. Peter Nash10,
  11. Christian F Opitz11,
  12. Lewis J Rubin12,
  13. James R Seibold13,
  14. Oliver Distler14,
  15. Daniel E Furst15,
  16. for the EPOSS Group
  1. 1Paris Descartes University, Rheumatology A Department, Cochin Hospital, APHP, Paris, France
  2. 2Department of Rheumatology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
  3. 3Institute for Clinical Pharmacology, Technical University, Dresden, Germany
  4. 4German Rheumatism Research Centre, Berlin, Germany
  5. 5Division of Rheumatology/ZAFES, J.W. Goethe University, Frankfurt, Germany
  6. 6Centre for Rheumatology, Royal Free and University College, Medical School, London, UK
  7. 7Hamburger Zentrum für Kinder- und Jugendrheumatologie Kompetenz-Zentrum für Sklerodermie im Kindesalter Am Klinikum Eilbek, Hamburg, Germany
  8. 8Service de Pneumologie et Reanimation Respiratoire, Centre des Maladies Vasculaires Pulmonaires, Hopital Antoine-Beclere, Université Paris-Sud, Clamart, France
  9. 9Department of Medicine, Division of Rheumatology, Denothe Center, University of Florence, Florence, Italy
  10. 10Rheumatology Research Unit, Cotton Tree, Sunshine Coast, Queensland, Australia
  11. 11Medizinische Klinik II, DRK-Kliniken Berlin, Westend, Berlin, Germany
  12. 12Division of Pulmonary and Critical Care Medicine, University of California, San Diego, School of Medicine, La Jolla, California, USA
  13. 13University of Michigan Scleroderma Program, Ann Arbor, Michigan, USA
  14. 14Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
  15. 15Division of Rheumatology, Department of Medicine, David Geffen School at UCLA, Los Angeles, California, USA
  1. Correspondence to Daniel E Furst, Division of Rheumatology, Department of Medicine, David Geffen School at UCLA, 1000 Veteran Avenue, Room 32-59, Los Angeles, CA 90095-1670, USA; defurst{at}


Objective To assess the validity of the 6 min walk test (6MWT) in pulmonary arterial hypertension secondary to systemic sclerosis (PAH-SSc) according to the OMERACT filter.

Methods A systematic literature search was conducted from 1966 through June 2009. The assessment of validation of the 6MWT was based on the OMERACT filter criteria with the domains ‘truth’, ‘discrimination’ and ‘feasibility’.

Results From the 57 articles identified, 9 (16%) were analysed. The 6MWT had face validity as it has been accepted by the registration agencies as a surrogate of PAH-SSc. It was sensitive to change in response to therapy, with effect sizes ranging from 0.30 to 1.37 with a parallel variation of haemodynamic parameters measured by right heart catheterisation. Feasibility was also validated. Content validity was not confirmed as this test was not specific for PAH-SSc. There was some evidence that 6MWT might meet criterion/construct validity, reproducibility and sensitivity to change over time, but insufficient data were provided to fully validate these components.

Conclusions Current evidence suggests partial validation of the 6MWT in PAH-SSc according to the OMERACT filter. Further dedicated studies are needed to validate completely the 6MWT in PAH-SSc, taking into account the comorbidities interfering with the 6MWT.

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  • JA, OK-B, OD and DEF contributed equally to this work.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Competing interests None.