Factors affecting sensitivity and specificity of exercise electrocardiography. Multivariable analysis.


Journal Article

Unlike the predictive value of a diagnostic test, which depends on the prevalence of disease in the population tested, its sensitivity and specificity have been assumed to be constants. This assumption was examined in patients who had both exercise electrocardiography and cardiac catheterization. The effects on sensitivity of factors from clinical history, catheterization, and exercise performance were defined by multivariable logistic regression analysis in 1,401 patients with coronary disease; effects on specificity were defined by a similar analysis in 868 patients without coronary disease. Five factors had significant, independent effects on exercise electrocardiographic sensitivity: maximal exercise heart rate, number of diseased coronary arteries, type of angina, and the patient's age and sex. Only maximal exercise heart rate had a significant, independent effect on exercise electrocardiographic specificity. Thus, the sensitivity and specificity of exercise electrocardiography vary with clinical history, extent of disease, and treadmill performance; the sensitivity and specificity of other diagnostic tests may also vary.

Full Text

Duke Authors

Cited Authors

  • Hlatky, MA; Pryor, DB; Harrell, FE; Califf, RM; Mark, DB; Rosati, RA

Published Date

  • July 1, 1984

Published In

Volume / Issue

  • 77 / 1

Start / End Page

  • 64 - 71

PubMed ID

  • 6741986

Pubmed Central ID

  • 6741986

International Standard Serial Number (ISSN)

  • 0002-9343

Digital Object Identifier (DOI)

  • 10.1016/0002-9343(84)90437-6


  • eng

Conference Location

  • United States