Does the treadmill exercise test provide additional prognostic information beyond basic clinical measurements in patients with suspected coronary artery disease?
This methodological paper demonstrates that the yield of a new medical test should be evaluated based on the additional prognostic information it provides beyond basic clinical evaluation, using the treadmill test as an example.
A method is presented for evaluating the amount of information a medical test provides about individual patients. Emphasis is placed on the role of a test in the evaluation of patients with a chronic disease. In this context, the yield of a test is best interpreted by analyzing the prognostic information it furnishes. Information from the history, physical examination, and routine procedures should be used in assessing the yield of a new test. As an example, the method is applied to the use of the treadmill exercise test in evaluating the prognosis of patients with suspected coronary artery disease. The treadmill test is shown to provide surprisingly little prognostic information beyond that obtained from basic clinical measurements.
Frank E. Harrell (Fri,) studied this question.