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Estimating the likelihood of severe coronary artery disease.

Publication ,  Journal Article
Pryor, DB; Shaw, L; Harrell, FE; Lee, KL; Hlatky, MA; Mark, DB; Muhlbaier, LH; Califf, RM
Published in: Am J Med
May 1991

PURPOSE: To determine which clinical characteristics obtained by a physician during an initial clinical examination are important for estimating the likelihood of severe coronary artery disease, and to determine whether estimates based on these characteristics remain valid when applied prospectively and in different patient groups. PATIENTS AND METHODS: We examined clinical characteristics predictive of severe disease in 6,435 consecutive symptomatic patients referred for suspected coronary artery disease between 1969 and 1983. RESULTS: Eleven of 23 characteristics were important for estimating the likelihood of severe coronary artery disease. A model using these characteristics accurately estimated the likelihood of severe disease in an independent sample of 2,342 patients referred since 1983. The model also accurately estimated the prevalence of severe disease in large series of patients reported in the literature. CONCLUSIONS: These findings suggest that the clinician's initial evaluation can identify patients at high or low risk of anatomically severe coronary artery disease. Cost-conscious quality care is encouraged by identifying patients at higher risk for severe coronary artery disease who are most likely to benefit from further evaluation.

Duke Scholars

Published In

Am J Med

ISSN

0002-9343

Publication Date

May 1991

Volume

90

Issue

5

Start / End Page

553 / 562

Location

United States

Related Subject Headings

  • Risk Factors
  • Reproducibility of Results
  • Radiography, Thoracic
  • Prevalence
  • Predictive Value of Tests
  • Physical Examination
  • Middle Aged
  • Medical History Taking
  • Male
  • Likelihood Functions
 

Citation

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ICMJE
MLA
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Pryor, D. B., Shaw, L., Harrell, F. E., Lee, K. L., Hlatky, M. A., Mark, D. B., … Califf, R. M. (1991). Estimating the likelihood of severe coronary artery disease. Am J Med, 90(5), 553–562.
Pryor, D. B., L. Shaw, F. E. Harrell, K. L. Lee, M. A. Hlatky, D. B. Mark, L. H. Muhlbaier, and R. M. Califf. “Estimating the likelihood of severe coronary artery disease.Am J Med 90, no. 5 (May 1991): 553–62.
Pryor DB, Shaw L, Harrell FE, Lee KL, Hlatky MA, Mark DB, et al. Estimating the likelihood of severe coronary artery disease. Am J Med. 1991 May;90(5):553–62.
Pryor, D. B., et al. “Estimating the likelihood of severe coronary artery disease.Am J Med, vol. 90, no. 5, May 1991, pp. 553–62.
Pryor DB, Shaw L, Harrell FE, Lee KL, Hlatky MA, Mark DB, Muhlbaier LH, Califf RM. Estimating the likelihood of severe coronary artery disease. Am J Med. 1991 May;90(5):553–562.
Journal cover image

Published In

Am J Med

ISSN

0002-9343

Publication Date

May 1991

Volume

90

Issue

5

Start / End Page

553 / 562

Location

United States

Related Subject Headings

  • Risk Factors
  • Reproducibility of Results
  • Radiography, Thoracic
  • Prevalence
  • Predictive Value of Tests
  • Physical Examination
  • Middle Aged
  • Medical History Taking
  • Male
  • Likelihood Functions