What are factors in establishing good clinical outcomes from treadmill stress testing?

Updated: Nov 21, 2018
  • Author: David Akinpelu, MD, FACP; Chief Editor: Eric H Yang, MD  more...
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Answer

Exercise testing is a well-established procedure that has been in widespread clinical use for decades. Although it is generally safe, both myocardial infarction and death have been reported and can be expected to occur at a rate of 1 incident per 2500 tests. Therefore, it is vital to use good clinical judgment when deciding which patients should undergo exercise testing.

Factors that are important in establishing good clinical outcomes from exercise testing include the following:

  • The quality, expertise, and experience of the professional and technical staff performing and interpreting the study (to reduce observer error)

  • The sensitivity, specificity, and accuracy of the technique (to establish limitations of this procedure)

  • The cost and accuracy of the technique as compared with more expensive imaging procedures (to establish the risk-to-benefit ratio, to determine the effect of positive or negative results on clinical decision making, and, to weigh the potential psychological benefits of patient reassurance)


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