Decision boundaries and receiver operating characteristic curves: New methods for determining accelerometer cutpoints

We propose and evaluate the utility of an alternative method ( decision boundaries) for establishing physical activity intensity-related accelerometer cutpoints. Accelerometer data collected from seventy- six 11- to 14- year- old boys during controlled bouts of moderate- and vigorous- intensity field physical activities were assessed. Mean values and standard deviations for moderate- and vigorous- intensity activities were obtained and normal equivalents generated. The decision boundary ( the point of intersection of overlapping distributions) was used to create a lower- bound vigorous- intensity cutpoint. Receiver operating characteristic ( ROC) curves compared the sensitivity and specificity of the new cutpoint and mean values with the actual activity. There was a 96.5% probability that participants performing vigorous- intensity physical activity were accurately classified when using the decision boundary of 6700 counts per minute, in contrast to the 50% accurately classified when the mean value was used. Inspection of the empirical ROC curve indicated that the decision boundary provided the optimal threshold to distinguish between moderate and vigorous physical activity for this dataset. In conclusion, decision boundaries reduced the error associated with determining accelerometer threshold values. Applying these methods to accelerometer data collected in specific populations will improve the precision with which accelerometer thresholds can be identified.