Open AccessRationale and Design of the Henry Ford ExercIse Testing Project (The FIT Project)
Author(s) -
AlMallah Mouaz H.,
Keteyian Steven J.,
Brawner Clinton A.,
Whelton Seamus,
Blaha Michael J.
Publication year - 2014
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22302
Subject(s) - medicine , cardiorespiratory fitness , myocardial infarction , population , metabolic equivalent , physical fitness , medical record , retrospective cohort study , emergency medicine , revascularization , treadmill , stress testing (software) , physical therapy , physical activity , environmental health , computer science , programming language
Although physical fitness is a powerful prognostic marker in clinical medicine, most cardiovascular population‐based studies do not have a direct measurement of cardiorespiratory fitness. In line with the call from the National Heart Lung and Blood Institute for innovative, low‐cost, epidemiologic studies leveraging electronic medical record ( EMR ) data, we describe the rationale and design of the Henry Ford ExercIse Testing Project (The FIT Project). The FIT Project is unique in its combined use of directly measured clinical exercise data retrospective collection of medical history and medication treatment data at the time of the stress test, retrospective supplementation of supporting clinical data using the EMR and administrative databases and epidemiologic follow‐up for cardiovascular events and total mortality via linkage with claims files and the death registry. The FIT Project population consists of 69 885 consecutive physician‐referred patients (mean age, 54 ± 10 years; 54% males) who underwent Bruce protocol treadmill stress testing at Henry Ford Affiliated Hospitals between 1991 and 2009. Patients were followed for the primary outcomes of death, myocardial infarction, and need for coronary revascularization. The median estimated peak metabolic equivalent ( MET ) level was 10, with 17% of the patients having a severely reduced fitness level ( METs < 6). At the end of the follow‐up duration, 15.9%, 5.6%, and 6.7% of the patients suffered all‐cause mortality, myocardial infarction, or revascularization procedures, respectively. The FIT Project is the largest study of physical fitness to date. With its use of modern electronic clinical epidemiologic techniques, it is poised to answer many clinically relevant questions related to exercise capacity and prognosis.