Use of electrocardiographic-thallium exercise testing in clinical practice

Journal Article · Wed Feb 01 00:00:00 EST 1984 · J. Am. Coll. Cardiol.; (United States)

DOI:https://doi.org/10.1016/S0735-1097(84)80009-1· OSTI ID:7016341

Gitler, B; Fishbach, M; Steingart, R M

Although there is a great deal of data on the accuracy of combined electrocardiographic-thallium exercise testing, little is known about the use of these tests in clinical practice. A quantitative likelihood system was employed to characterize referral patterns for such testing, and the impact of test results on the likelihood of coronary artery disease was examined. Two hundred thirteen subjects consecutively referred for the purpose of establishing or excluding the presence of coronary artery disease were studied. No subject had a history of a prior myocardial infarction. By historical evaluation, 96 had a low likelihood of coronary disease (less than or equal to 0.20), 88 an intermediate likelihood (0.21 to 0.80) and 29 a high likelihood (greater than 0.80). As anticipated from theoretical analyses, testing produced the greatest shifts in disease likelihood in subjects with an intermediate pretest disease likelihood, and confirmed the historical evaluation in patients at the extremes of pretest disease likelihood. Therefore, although electrocardiographic-thallium stress testing is best suited for subjects with intermediate pretest disease likelihood, the majority of referrals had either a high or low likelihood. Clinicians appear to value confirmatory results in patients at the extremes of pretest disease likelihood. Electrocardiographic exercise testing would serve a similar purpose.

• Research Organization: Montefiore Medical Center, New York, NY
• OSTI ID: 7016341
• Journal Information: J. Am. Coll. Cardiol.; (United States), Vol. 3:2
• Country of Publication: United States
• Language: English

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