Key result
Private referral linked to ~4-fold higher odds of inappropriate treadmill exercise stress testing.
Why the study?
Inappropriate referrals for treadmill exercise stress tests increase healthcare spending and unnecessary interventions, with differences between public and private health systems.
What is the prevalence and what are the predictors of inappropriate referrals for treadmill exercise stress tests for CAD assessment?
Population
191 patients referred for treadmill exercise stress test for CAD assessment in Northeast Brazil
Comparison
Public health system vs private health system referrals
Design
Cross-sectional study
Authors
Loading...
Private referrals associate with excess inappropriate stress testing; leaves open whether system-level referral reforms can improve appropriate CAD evaluation.
Cross-Sectional (n=191)
Yes
What is the prevalence and what are the predictors of inappropriate referrals for treadmill exercise stress tests for CAD assessment?
Odds Ratio: 4.3 (95% CI 2–9.1)
Absolute Event Rate: 87% vs 57%
p-value: p=<0.001
The vast majority of treadmill exercise stress test referrals for CAD assessment were inappropriate, with private health system availability being a major independent predictor.
Silva et al. (2015) conducted a cross-sectional in Coronary artery disease (n=191). Private health system vs. Public health system was evaluated on Inappropriate referral for treadmill exercise stress test (OR 4.3, 95% CI 2.0-9.1, p=<0.001). Referral from the private health system was the major independent predictor of inappropriate treadmill exercise stress testing, increasing the odds by 4.3-fold compared to the public system.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: