A simplified approach for evaluating multiple test outcomes and multiple disease states in relation to the exercise thallium-201 stress test in suspected coronary artery disease

Stewart G. Pollock, Denny D. Watson, Robert S. Gibson, George A. Beller, Sanjiv Kaul

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    5 Scopus citations


    This study describes a simplified approach for the interpretation of etectrocardiographic and thallium-201 imaging data derived from the same patient during exercise. The 383 patients in this study had also undergone selective coronary adenography within 3 months of the exercise test. This matrix approach allows for multiple test outcomes (both tests positive, both negative, 1 test positive and 1 negative) and multiple disease states (no coronary artery disease vs 1-vessel vs multivessel coronary artery disease). Because this approach analyzes the results of 2 test outcomes simultaneously rather than serially, it also negates the lack of test independence, if such an effect is present. It is also demonstrated that ST-segment depression on the electrocardiogram and defects on initial thallium-201 images provide conditionally independent information regarding the presence of coronary artery disease in patients without prior myocardial infarction. In contrast, ST-segment depression on the electrocardiogram and redistribution on the delayed thallium-201 images may not provide totally independent information regarding the presence of exercise-induced ischemia in patients with or without myocardial infarction.

    Original languageEnglish (US)
    Pages (from-to)466-470
    Number of pages5
    JournalThe American journal of cardiology
    Issue number8
    StatePublished - Sep 1 1989


    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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