Factors affecting sensitivity and specificity of exercise electrocardiography. Multivariable analysis.
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.
Duke Scholars
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DOI
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Related Subject Headings
- Sex Factors
- Middle Aged
- Male
- Humans
- Heart Rate
- General & Internal Medicine
- Female
- Exercise Test
- Electrocardiography
- Coronary Disease
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Sex Factors
- Middle Aged
- Male
- Humans
- Heart Rate
- General & Internal Medicine
- Female
- Exercise Test
- Electrocardiography
- Coronary Disease