The Single-Cutoff Trap: Implications For Bayesian Analysis of Stress Electrocardiograms.
Publication/Presentation Date
7-1-1989
Abstract
Quantitative analysis of exercise electrocardiograms has been emphasized by many investigators. Specific problems have been found when a single cutoff is used to define a positive or a negative test: a single cutoff does not distinguish stress electrocardiography results that are slightly positive from those that are markedly positive. This may lead clinicians to underweigh strong evidence for or against coronary artery disease. This study evaluated clinicians' quantitative analysis of stress electrocardiograms. Two hundred and thirty-five physicians interpreted the results of mildly positive (1.2 mm ST-segment depression) and strongly positive (2.2 mm ST-segment depression) stress electrocardiograms. Their posttest probability estimates were too high for a mildly positive test (0.62 +/- 0.02 versus actual of 0.38; p less than 0.001) and too low for a strongly positive test (0.77 +/- 0.01 versus actual of 0.98; p less than 0.001). Physicians should understand decision aids and should use multiple rather than single cutoffs to interpret the results of stress electrocardiography.
Volume
9
Issue
3
First Page
176
Last Page
180
ISSN
0272-989X
Published In/Presented At
Young, M. J., Fried, L. S., Eisenberg, J. M., Hershey, J. C., & Williams, S. V. (1989). The single-cutoff trap: implications for Bayesian analysis of stress electrocardiograms. Medical Decision Making: An International Journal Of The Society For Medical Decision Making, 9(3), 176-180.
Disciplines
Medical Sciences | Medicine and Health Sciences
PubMedID
2668678
LVHN link
http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=2668678&site=ehost-live&scope=site
Department(s)
Department of Medicine, Department of Medicine Faculty
Document Type
Article