학술논문

Methodologic problems in exercise testing research. Are we solving them
Document Type
Journal Article
Author
Source
Arch. Intern. Med.; (United States); 148:6
Subject
62 RADIOLOGY AND NUCLEAR MEDICINE BIOMEDICAL RADIOGRAPHY
ACCURACY
HEART
SCINTISCANNING
COMPARATIVE EVALUATIONS
EXERCISE
REVIEWS
THALLIUM ISOTOPES
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DOCUMENT TYPES
ISOTOPES
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIOISOTOPE SCANNING
RADIOLOGY 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
550602 -- Medicine-- External Radiation in Diagnostics-- (1980-)
Language
English
Abstract
To evaluate the comparative effects of methodologic factors on the reported accuracies of two standard exercise tests, 56 publications comparing the exercise thallium scintigram with the coronary angiogram were analyzed for conformation to five methodologic standards. Analyzed were adequate definition of study group, avoidance of a limited challenge group, avoidance of workup bias, and blinded analysis of the coronary angiogram and myocardial scintigram. Study group characteristics and technical factors were also reviewed. Better conformation with methodologic standards was found than has been reported previously for treadmill exercise testing. Furthermore, study group characteristics and technical factors were better predictors of sensitivity and specificity than were methodologic deficiencies. Only workup bias and test blinding were significantly associated with test accuracy. The percentage of patients with previous myocardial infarction had the highest correlation and was independently and directly related to sensitivity and inversely related to specificity. 77 references.