Limitations of Electrocardiographic Exercise Testing

Abstract

The Coronary Artery Surgery Study on exercise stress testing, discussed this week in the Journal^,1 is an important addition to a recent series of articles exploring the reliability and limitations of exercise testing in the detection of underlying coronary-artery disease.^{2 3 4 5 6} In particular, the results of the study demonstrate that clinicians must be just as cognizant of the important diagnostic implications of Bayes' theorem of conditional probability as are statisticians.Bayes' theorem states that, although the reliability of a diagnostic test is defined by the test's sensitivity* and specificity,* a test cannot be adequately interpreted without reference to the prevalence . . .