The predictability as to a positive or negative outcome of treadmill exercise stress testing in 341 consecutively studied patients referred for diagnostic purposes is presented. A clinical decision as to the result was derived by asking 2 simple questions and reviewing the pretest ECG. Additional clinical logistics included the type of physician ordering the study, smoking history, symptoms, and basic patient history. The predictable accuracy was 77.7% for the total patient group and 81.5% when the questionable cases (reflecting a neutral or ambivalent cardi ologist's opinion) were eliminated.
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References
1.
Stein JH, Uretz EF, Parillo JE, et al: Cost and appropriateness of radionuclide exercise stress testing by cardiologists and noncardiologists. Am J Cardiol77:139-142, 1996.
2.
Diamond GA, Denton TA, Berman DS, et al: Prior restraint : A Bayesian perspective on the optimization of technology utilization for diagnosis of coronary artery disease. Am J Cardiol76:82-86, 1995.
3.
Froelicher, VF :Are we overdoing diagnostic and management approaches to coronary artery disease? Cardiol Board Review12:27-34, 1995.
4.
Marcus R., Lowe R., Froelicher VF, et al: The exercise test as gatekeeper: Limiting access or appropriately directing resources? Chest107:1442-1446, 1995.
5.
Bader DS, McInnis KJ, Maguire TE, et al: Accuracy of a pretest questionnaire in exercise test protocol selection. Am J Cardiol85:767-770, 2000.
6.
Evans MA, Christian TF: Is thallium imaging for predicting severe coronary artery disease justified ? Cardiol Review13:19-22, 1996.
7.
Christian TF , Miller TD, Bailey KR, et al: Exercise tomographic thallium 201 imaging in patients with severe coronary artery disease and normal electrocardiograms . Ann Intern Med121:825-832, 1994.
8.
Krone RJ, Gregory JJ, Freedland KE, et al: Limited usefulness of exercise testing and thallium scintigraphy in evaluation of ambulatory patients several months after recovery from an acute coronary event: Implications for management of stable coronary heart disease. Am J Cardiol24:1274-1281, 1994 .
9.
Pilote L., Pashkow F., Thomas JD, et al: Clinical yield and cost of exercise treadmill testing to screen for coronary artery disease in asymptomatic adults. Am J Cardiol81:219-224, 1998.
10.
Bodenheimer MM: Risk stratification in coronary disease : A contrary viewpoint. Ann Intern Med116:927-936, 1992.
