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Journal of General Internal Medicine
Erschienen in: Journal of General Internal Medicine 8/2009

01.08.2009 | Original Article

Is an Exercise Tolerance Test Indicated Before Beginning Regular Exercise? A Decision Analysis

verfasst von: Dror Lahav, MD, Moshe Leshno, MD, Mayer Brezis, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 8/2009

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ABSTRACT

BACKGROUND AND OBJECTIVE

The present study, using a decision analysis, evaluates whether an exercise tolerance test (ETT) is indicated before initiating regular physical activity to reduce the risk of sudden death during exercise training.

DESIGN

The study encompasses a decision tree, Monte Carlo simulation, and utility analysis for adults at low to high risk for coronary disease, with a time horizon of five years, with or without routine ETT screening before initiating physical activity.

MEASURES

Mortality in Monte Carlo simulation; expected values in utility analysis.

RESULTS

Routine screening decreases mortality in intermediate to high-risk populations but not in low-risk persons. At all risk levels, the number of exercise-induced deaths prevented is less than the added number of deaths from angiography. Utility analysis indicates inferiority of routine screening, regardless of risk. Personal preferences (perceived stigma from having coronary disease and perceived benefit of regular exercise on quality of life) have a strong influence on the optimal choice.

CONCLUSION

Routine screening before initiating regular exercise is not recommended for the purpose of reducing the risk of sudden death during exercise training.
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Metadaten
Titel
Is an Exercise Tolerance Test Indicated Before Beginning Regular Exercise? A Decision Analysis
verfasst von
Dror Lahav, MD
Moshe Leshno, MD
Mayer Brezis, MD, MPH
Publikationsdatum
01.08.2009
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 8/2009
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-009-1029-2

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