Systematic review and modelling of the investigation of acute and chronic chest pain presenting in primary care

Health Technology Assessment

Volumn 8, Issue 2, 2004, Pages

  Mant, J ^a   McManus, R J ^a   Oakes, R A L ^a   Delaney, B C ^a   Barton, P M ^a   Deeks, J J ^b   Hammersley, L ^a   Davies, R C ^c   Davies, M K ^d   Hobbs, F D R ^a  

^a UNIVERSITY OF BIRMINGHAM   (United Kingdom)

^b UNIVERSITY OF OXFORD   (United Kingdom)

^c SANDWELL GENERAL HOSPITAL   (United Kingdom)

^d UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

TROPONIN;

ACUTE HEART INFARCTION; ANGINA PECTORIS; ANGIOGRAPHY; BIBLIOGRAPHIC DATABASE; BLOOD CLOT LYSIS; CALCULATION; CHRONIC PAIN; CINAHL; CLINICAL FEATURE; COCHRANE LIBRARY; CONFERENCE PAPER; COST BENEFIT ANALYSIS; COST EFFECTIVENESS ANALYSIS; DIAGNOSTIC VALUE; EARLY DIAGNOSIS; EMBASE; EXERCISE ELECTROCARDIOGRAPHY; EXERCISE TEST; HEALTH CARE ACCESS; HEART MUSCLE ISCHEMIA; HOSPITAL ADMISSION; HUMAN; INFORMATION PROCESSING; ISCHEMIC HEART DISEASE; MEDICAL SPECIALIST; MEDLINE; MONTE CARLO METHOD; OUTCOMES RESEARCH; PAIN; PAIN CLINIC; PALPATION; PATIENT REFERRAL; PLEURAL PAIN; PREDICTION; PRIMARY MEDICAL CARE; Q WAVE; REST; REVIEW; SENSITIVITY AND SPECIFICITY; SIMULATION; ST SEGMENT ELEVATION; STATISTICAL MODEL; TELEMETRY; THORAX PAIN; TIME;

EID: 10744233145     PISSN: 13665278     EISSN: None     Source Type: Journal    
DOI: 10.3310/hta8020     Document Type: Review

References (244)

1. British Heart Foundation Statistics Database. URL: http://www.dphpc.ox.ac.uk/bhfhprg/stats/2000/index.html
2. HMSO. Saving lives: our healthier nation. London: HMSO; 1998.
3. Department of Health. National service framework for coronary heart disease. London: HMSO; 2000.
4. Rawles J, Sinclair C, Jennings K, Ritchie L, Waugh N. Call to needle times after acute myocardial infarction in urban and rural areas in northeast Scotland: prospective observational study. BMJ 1998;317:576-8.
5. Appleby P, Baigent C, Collins R, et al. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet 1994;343:311-22.
6. Rawles J. Magnitude of benefit from earlier thrombolytic treatment in acute myocardial infarction: new evidence from Grampian Region Early Anistreplase Trial (GREAT). BMJ 1996; 312:212-15.
7. Rawles J. Halving of mortality at 1 year by domiciliary thrombolysis in the Grampian Region Early Anistreplase Trial (GREAT). J Am Coll Cardiol 1994;23:1-5.
8. Llevadot J, Giugliano RP, Antman EM. Bolus fibrinolytic therapy in acute myocardial infarction. JAMA 2001;286:442-9.
9. Roberts RR, Zalenski RJ, Mensah EK, et al. Costs of an emergency department-based accelerated diagnostic protocol vs hospitalization in patients with chest pain: a randomized controlled trial. JAMA 1997;278:1670-6.
10. Launbjerg J, Fruergaard P, Madsen JK, Mortensen LS, Hansen JE. Ten year mortality in patients with suspected acute myocardial infarction. BMJ 1994; 308:1196-9.
11. Adams J, Trent R, Rawles J. Earliest electrocardiographic evidence of myocardial infarction: implications for thrombolytic treatment. The GREAT Group. BMJ 1993; 307:409-13.
12. Grijseels EWM, Deckers JW, Hoes AW, et al. Implementation of a pre-hospital decision rule in general practice. Triage of patients with suspected myocardial infarction. Euro Heart J 1996;17:89-95.
13. Wise CM. Chest wall syndromes. Curr Opin Rheumatol 1994;6:197-202.
14. Mayou R. Chest pain, palpitations and panic. J Psychosom Res 1998;44:53-70.
15. Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med 1979; 300:1350-8.
16. Pryor DB, Harrell FEJ, Lee KL, Califf RM, Rosati RA. Estimating the likelihood of significant coronary artery disease. Am J Med 1983;75:771-80.
17. Do D, West JA, Morise A, Atwood E, Froelicher V. A consensus approach to diagnosing coronary artery disease based on clinical and exercise test data. Chest 1997;111:1742-9.
18. Capewell S, McMurray J. 'Chest pain - please admit': is there an alternative? A rapid cardiological assessment service may prevent unnecessary admissions. BMJ 2000;320:951-2.
19. Goodacre SW. Should we establish chest pain observation units in the UK? A systematic review and critical appraisal of the literature. J Accid Emerg Med 2000;17:1-6.
20. Hlatky MA, Pryor DB, Harrell FEJ, Califf RM, Mark DB, Rosati RA. Factors affecting sensitivity and specificity of exercise electrocardiography. Multivariable analysis. Am J Med 1984;77:64-71.
21. Jakobsson A, Ohlin P, Pahlm O. Does a computer-based ECG-recorder interpret electrocardiograms more efficiently than physicians? Clin Physiol 1985;5:417-23.
22. Jaeschke R, Guyatt GH, Sackett DL. Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group. JAMA 1994;271:703-7.
23. Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D, Rajakangas AM, Pajak A. Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 1994;90:583-612.
24. Maynard SJ, Scott GO, Riddell JW, Adgey AA. Management of acute coronary syndromes. BMJ 2000;321:220-3.
25. Deeks JJ. Systematic reviews of evaluations of diagnostic and screening tests. In: Egger M, Davey Smith G, Altman DG, editors. Systematic reviews in health care: meta-analyses in context. London: BMJ Books; 2001. pp. 248-82.
26. Briggs AH, Gray AM. Handling uncertainty when performing economic evaluation of healthcare interventions. Health Technol Assess 1999;3(2):1-134.
27. Fibrinolytic Therapy Trialists' (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet 1994;343:311-22.
28. Morrison LJ, Verbeek PR, McDonald AC, Sawadsky BV, Cook DJ. Mortality and prehospital thrombolysis for acute myocardial infarction: a meta-analysis. JAMA 2000;283:2686-92.
29. Ebell MH, White LL, Weismantel D. A systematic review of troponin T and I values as a prognostic tool for patients with chest pain. J Fam Pract 2000;49:746-53.
30. BMA. British National Formulary. London: British Medical Association and Royal Pharmaceutical Society of Great Britain; 2002.
31. Department of Health. NHS reference costs 2000. URL: http://www.doh.gov.uk/nhsexec/refcosts.htm. 2002.
32. Office for National Statistics. Morbidity statistics from general practice. London: Office for National Statistics; 1998.
33. Wood DA, Kotseva K, Fox K, Bakhai A, Bowker J. Health care needs assessment: coronary heart disease. In: Stevens A, Raftery J, Mant J, Simpson S, editors. Health care needs assessment: the epidemiological based needs assessment reviews. 2nd ed. Oxford: Radcliffe Medical Press, 2004 (in press).
34. Office for National Statistics. Population at mid-2000: England and Wales; estimated resident population by single year of age and gender. URL: http://www.statistics.gov.uk/statbase/datasets2.asp?th=3&B1=Show+Li. 2002.
35. Jain D, Fluck D, Sayer JW, Ray S, Paul EA, Timmis AD. One-stop chest pain clinic can identify high cardiac risk. J R Coll Phys Lond 1997;31:401-4.
36. Fisher L. Coronary-artery surgery study (CASS) - a randomized trial of coronary-artery bypass-surgery - survival-data. Circulation 1983;68:939-50.
37. Kotler TS, Diamond GA. Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary artery disease. Ann Intern Med 1990;113:684-702.
38. Volmink JA, Newton JN, Hicks NR, Sleight P, Fowler GH, Neil HA. Coronary event and case fatality rates in an English population: results of the Oxford myocardial infarction incidence study. The Oxford Myocardial Infarction Incidence Study Group. Heart 1998;80:40-4.
39. WHO. World health statistics annual, 1978. Geneva: World Health Organization; 1978.
40. Underwood SR, Godman B, Salvani S, Ogle JR, Ell PJ. Economics of myocardial perfusion imaging in Europe - the EMPIRE study. Eur Heart J 1999;20:157-66.
41. Fesmire FM, Percy RF, Wears RL, MacMath TL. Initial ECG in Q wave and non-Q wave myocardial infarction. Ann Emerg Med 1989;18:741-6.
42. Fesmire FM, Percy RF, Bardoner JB, Wharton DR, Calhoun FB. Usefulness of automated serial 12-lead ECG monitoring during the initial emergency department evaluation of patients with chest pain. Ann Emerg Med 1998;31:3-11.
43. Jonsbu J, Aase O, Rollag A, Liestol K, Erikssen J. Prospective evaluation of an EDB-based diagnostic program to be used in patients admitted to hospital with acute chest pain. Eur Heart J 1993;14:441-6.
44. Kudenchuk PJ, Maynard C, Cobb LA, et al. Utility of the prehospital electrocardiogram in diagnosing acute coronary syndromes: the Myocardial Infarction Triage and Intervention (MITI) Project. J Am Coll Cardiol 1998;32:17-27.
45. Lee TH, Weisberg MC, Brand DA, Rouan GW, Goldman L. Candidates for thrombolysis among emergency room patients with acute chest pain. Potential true- and false-positive rates. Ann Intern Med 1989;110:957-62.
46. Patel DJ, Holdright DR, Knight CJ, et al. Early continuous ST segment monitoring in unstable angina: prognostic value additional to the clinical characteristics and the admission electrocardiogram. Heart 1996;75:222-8.
47. Rouan GW, Lee TH, Cook EF, Brand DA, Weisberg MC, Goldman L. Clinical characteristics and outcome of acute myocardial infarction in patients with initially normal or nonspecific electrocardiograms (a report from the Multicenter Chest Pain Study). Am J Cardiol 1989;64:1087-92.
48. Zalenski RJ, Rydman RJ, Sloan EP, et al. Value of posterior and right ventricular leads in comparison to the standard 12-lead electrocardiogram in evaluation of ST-segment elevation in suspected acute myocardial infarction. Am J Cardiol 1997;79:1579-85.
49. Dalton JA, Brown L, Carlson J, McNutt R, Greer SM. An evaluation of facial expression displayed by patients with chest pain. Heart Lung 1999;28:168-74.
50. Goldman L, Weinberg M, Weisberg M, et al. A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain. N Engl J Med 1982;307:588-96.
51. Gray D, Hampton JR. Sensitivity and specificity of the initial working diagnosis in acute myocardial infarction: implications for thrombolysis. Int J Epidemiol 1993;22:222-7.
52. Herlihy T, McIvor ME, Cummings CC, Siu CO, Alikahn M. Nausea and vomiting during acute myocardial infarction and its relation to infarct size and location. Am J Cardiol 1987;60:20-2.
53. Lee TH, Cook EF, Weisberg M, Sargent RK, Wilson C, Goldman L. Acute chest pain in the emergency room. Identification and examination of low-risk patients. Arch Intern Med 1985; 145:65-9.
54. Logan RL, Wong F, Barclay J. Symptoms associated with myocardial infarction: are they of diagnostic value? N Z Med J 1986;99:276-8.
55. Tierney WM, Fitzgerald J, McHenry R, et al. Physicians' estimates of the probability of myocardial infarction in emergency room patients with chest pain. Med Decis Making 1986;6:12-17.
56. Aufderheide TP, Hendley GE, Thakur RK, et al. The diagnostic impact of prehospital 12-lead electrocardiography. Ann Emerg Med 1990; 19:1280-7.
57. Aufderheide TP, Hendley GE, Woo J, Lawrence S, Valley V, Teichman SL. A prospective evaluation of prehospital 12-lead ECG application in chest pain patients. J Electrocardiol 1992;24 Suppl:8-13.
58. Foy SG, Kennedy IC, Ikram H, Low CJ, Shirlaw TM, Crozier IG. The early diagnosis of acute myocardial infarction. Aust N Z J Med 1991; 21:335-7.
59. Hands ME, Cook EF, Stone PH, et al. Electrocardiographic diagnosis of myocardial infarction in the presence of complete left bundle branch block. Am Heart J 1988;116:23-31.
60. Rude RE, Poole WK, Muller JE, et al. Electrocardiographic and clinical criteria for recognition of acute myocardial infarction based on analysis of 3,697 patients. Am J Cardiol 1983;52:936-42.
61. Miller DH, Kligfield P, Schreiber TL, Borer JS. Relationship of prior myocardial infarction to false-positive electrocardiographic diagnosis of acute injury in patients with chest pain. Arch Intern Med 1987;147:257-61.
62. Short D. Diagnosis of slight and subacute coronary attacks in the community. Br Heart J 1981; 45:299-310.
63. Solomon CG, Lee TH, Cook EF, et al. Comparison of clinical presentation of acute myocardial infarction in patients older than 65 years of age to younger patients: the Multicenter Chest Pain Study experience. Am J Cardiol 1989;63:772-6.
64. Jonsbu J, Rollag A, Aase O, et al. Rapid and correct diagnosis of myocardial infarction: standardized case history and clinical examination provide important information for correct referral to monitored beds. J Intern Med 1991;229:143-9.
65. Berger JP, Buclin T, Haller E, Van Melle G, Yersin B. Right arm involvement and pain extension can help to differentiate coronary diseases from chest pain of other origin: a prospective emergency ward study of 278 consecutive patients admitted for chest pain. J Intern Med 1990;227:165-72.
66. Weaver WD, Eisenberg MS, Martin JS, et al. Myocardial Infarction Triage and Intervention Project - phase I: patient characteristics and feasibility of prehospital initiation of thrombolytic therapy. J Am Coll Cardiol 1990;15:925-31.
67. Kellett J. Early diagnosis of acute myocardial infarction by either electrocardiogram or a logistic regression model: portability of a predictive instrument of acute cardiac ischemia to a small rural coronary care unit. Can J Cardiol 1997;13:1033-8.
68. Singer AJ, Brogan GX, Valentine SM, McCuskey C, Khan S, Hollander JE. Effect of duration from symptom onset on the negative predictive value of a normal ECG for exclusion of acute myocardial infarction. Ann Emerg Med 1997;29:575-9.
69. Mair J, Smidt J, Lechleitner P, Dienstl F, Puschendorf B. Rapid accurate diagnosis of acute myocardial infarction in patients with non-traumatic chest pain within 1 h of admission. Coronary Artery Dis 1995;6:539-45.
70. Kellett J, Graham J. Referral for coronary angiography after exercise testing: traditional decision-making versus decision analysis. QJM 1995;88:401-8.
71. Otto LA, Aufderheide TP. Evaluation of ST segment elevation criteria for the prehospital electrocardiographic diagnosis of acute myocardial infarction. Ann Emerg Med 1994;23:17-24.
72. Yusuf S, Pearson M, Sterry H, et al. The entry ECG in the early diagnosis and prognostic stratification of patients with suspected acute myocardial infarction. Eur Heart J 1984;5:690-6.
73. Gustafsson G, Dellborg M, Lindahl B, Wallentin L. Dynamic vectorcardiography for early diagnosis of acute myocardial infarction compared with 12-lead electrocardiogram. BIOMACS Study Group. Coron Artery Dis 1996;7:871-6.
74. Zalenski RJ, Cooke D, Rydman R, Sloan EP, Murphy DG. Assessing the diagnostic value of an ECG containing leads V4R, V8, and V9: the 15-lead ECG. Ann Emerg Med 1993;22:786-93.
75. Justis DL, Hession WT. Accuracy of 22-lead ECG analysis for diagnosis of acute myocardial infarction and coronary artery disease in the emergency department: a comparison with 12-lead ECG. Ann Emerg Med 1992;21:1-9.
76. Grim PS, Feldman T, Childers RW. Evaluation of patients for the need of thrombolytic therapy in the prehospital setting. Ann Emerg Med 1989; 18:483-8.
77. Foster DB, Dufendach JH, Barkdoll CM, Mitchell BK. Prehospital recognition of AMI using independent nurse/paramedic 12-lead ECG evaluation: impact on in-hospital times to thrombolysis in a rural community hospital. Am J Emerg Med 1994;12:25-31.
78. Mair J, Smidt J, Lechleitner P, Dienstl F, Puschendorf B. A decision tree for the early diagnosis of acute myocardial infarction in nontraumatic chest pain patients at hospital admission. Chest 1995;108:1502-9.
79. Grijseels EW, Deckers JW, Hoes AW, et al. Prehospital triage of patients with suspected myocardial infarction. Evaluation of previously developed algorithms and new proposals. Eur Heart J 1995;16:325-32.
80. Bell MR, Montarello JK, Steele PM. Does the emergency room electrocardiogram identify patients with suspected myocardial infarction who are at low risk of acute complications? Aust N Z J Med 1990;20:564-9.
81. Heden B, Ohlin H, Rittner R, Edenbrandt L. Acute myocardial infarction detected in the 12-lead ECG by artificial neural networks. Circulation 1997;96:1798-802.
82. Herlitz J, Karlson BW, Karlsson T, Dellborg M, Hartford M, Luepker R. Diagnostic accuracy of physicians for identifying patients with acute myocardial infarction without an electrocardiogram. Experiences from the TEAHAT Trial. Cardiology 1995;86:25-7.
83. Baxt WG, Skora J. Prospective validation of artificial neural network trained to identify acute myocardial infarction. Lancet 1996;347:12-15.
84. Lee TH, Cook EF, Weisberg MC, Rouan GW, Brand DA, Goldman L. Impact of the availability of a prior electrocardiogram on the triage of the patient with acute chest pain. J Gen Intern Med 1990;5:381-8.
85. Behar S, Schor S, Kariv I, Barell V, Modan B. Evaluation of electrocardiogram in emergency room as a decision-making tool. Chest 1977; 71:486-91.
86. Baxt WG. Use of an artificial neural network for the diagnosis of myocardial infarction. Ann Intern Med 1991;115:843-8.
87. Karlson BW, Herlitz J, Wiklund O, Richter A, Hjalmarson A. Early prediction of acute myocardial infarction from clinical history, examination and electrocardiogram in the emergency room. Am J Cardiol 1991;68:171-5.
88. Sordyl CM. Clinical diagnosis of chest pain. Am J Crit Care 1995;4:413.
89. Rohl D, Kaddatz J, Thonke A. The diagnosis of acute myocardial infarction by the initial ECG and clinical presentation. Herz Kreislauf 1992;24:52-7.
90. Pozen MW, D'Agostino RB, Selker HP, Sytkowski PA, Hood WB Jr. A predictive instrument to improve coronary-care-unit admission practices in acute ischemic heart disease. A prospective multicenter clinical trial. N Engl J Med 1984; 310:1273-8.
91. Pozen MW, D'Agostino RB, Mitchell JB, et al. The usefulness of a predictive instrument to reduce inappropriate admissions to the coronary care unit. Ann Intern Med 1980;92:238-42.
92. Doyle Y, Conroy R, Mulcahy R. Can we improve on the diagnostic accuracy of chest pain in accident and emergency departments? Ir Med J 1988;81:21-4.
93. France RJ, Formolo JM, Penney DG. Value of notching and slurring of the resting QRS complex in the detection of ischemic heart disease. Clin Cardiol 1990;13:190-6.
94. el Gaylani N, Weston CF, Shandall A, Penny WJ, Buchalter MB. Experience of a rapid access acute chest pain clinic. Ir Med J 1997;90:139-40.
95. Newby DE, Fox KA, Flint LL, Boon NA. A 'same day' direct-access chest pain clinic: improved management and reduced hospitalization. QJM 1998;91:333-7.
96. Duncan B, Fulton M, Morrison SL, et al. Prognosis of new and worsening angina pectoris. BMJ 1976;i:981-5.
97. Gandhi MM, Lampe FC, Wood DA. Incidence, clinical characteristics, and short-term prognosis of angina pectoris. Br Heart J 1995;73:193-8.
98. Davie AP, Caesar D, Caruana L, et al. Outcome from a rapid-assessment chest pain clinic. QJM 1998;91:339-43.
99. Norell M, Lythall D, Coghlan G, et al. Limited value of the resting electrocardiogram in assessing patients with recent onset chest pain: lessons from a chest pain clinic. Br Heart J 1992;67:53-6.
100. O'Toole L, Channer KS. Direct access exercise electrocardiography: a new service that improves the management of suspected ischaemic heart disease in the community. Br Heart J 1995;73:200.
101. Sutcliffe SJ, Fox KF, Wood DA. How to set up and run a rapid access chest pain clinic. Br J Cardiol 2000;7:692-702.
102. Sutcliffe SJ, Wood DA. The impact of a rapid access chest pain clinic on the management of new angina in the community. J Am Coll Cardiol 1999; 33:392A (abstract).
103. Timmis AD. Speeding up cardiac care. ImpAct 1999;1:1-3.
104. Sutcliffe SJ, Wood DA. The impact of a rapid access chest pain clinic on the management of new angina in the community. J Am Coll Cardiol 1999; 33:392A (abstract).
105. GREAT Group. Feasibility, safety, and efficacy of domiciliary thrombolysis by general practitioners: Grampian Region Early Anistreplase Trial. BMJ 1992;305:548-53.
106. Rawles J, Sinclair C, Jennings K, Ritchie L, Waugh N. Audit of prehospital thrombolysis by general practitioners in peripheral practices in Grampian. Heart 1998;80:231-4.
107. Morris F, Brady WJ. ABC of clinical electrocardiography: acute myocardial infarction - Part I. BMJ 2002;324:831-4.
108. Macallan DC, Bell JA, Braddick M, Endersby K, Rizzo-Naudi J. The electrocardiogram in general practice: its use and its interpretation. J R Soc Med 1990;83:559-62.
109. McCrea WA, Saltissi S. Electrocardiogram interpretation in general practice: relevance to prehospital thrombolysis. Br Heart J 1993; 70:219-25.
110. Aufderheide TP, Keelan MH, Hendley GE, et al. Milwaukee prehospital chest pain project - Phase I: feasibility and accuracy of prehospital thrombolytic candidate selection. Am J Cardiol 1992;69:991-6.
111. Panju AA, Hemmelgarn BR, Guyatt GH, Simel DL. Is this patient having a myocardial infarction? JAMA 1998;280:1256-63.
112. Vale L, Silcock J, Rawles J. An economic evaluation of thrombolysis in a remote rural community. BMJ 1997;314:570-2.
113. Scottish Intercollegiate Guidelines Network. Management of stable angina. Edinburgh: SIGN; 2001.
114. Morise AP, Beto R. The specificity of exercise electrocardiography in women grouped by estrogen status. Int J Cardiol 1997;60:55-65.
115. Morise AP, Va W. Accuracy of heart rate-adjusted ST segments in populations with and without posttest referral bias. Am Heart J 1997;134:647-55.
116. Linhart JW, Laws JG, Satinsky JD. Maximum treadmill exercise electrocardiography in female patients. Circulation 1974;50:1173-8.
117. Nowak J, Hagerman I, Ylen M, Nyquist O, Sylven C. Electrocardiogram signal variance analysis in the diagnosis of coronary artery disease - a comparison with exercise stress test in an angiographically documented high prevalence population. Clin Cardiol 1993;16:671-82.
118. Sigurdsson E, Thorgeirsson G, Sigvaldason H, Sigfusson N. Unrecognized myocardial infarction: epidemiology, clinical characteristics, and the prognostic role of angina pectoris. The Reykjavik Study. Ann Intern Med 1995;122:96-102.
119. Kwok Y, Kim C, Grady D, Segal M, Redberg R. Meta-analysis of exercise testing to detect coronary artery disease in women. Am J Cardiol 1999; 83:660-6.
120. Dougan JP, Mathew TP, Riddell JW, et al. Suspected angina pectoris: a rapid-access chest pain clinic. QJM 2001;94:679-86.
121. Gandhi MM, Lampe FC, Wood DA. Incidence, clinical characteristics, and short-term prognosis of angina pectoris. Br Heart J 1995;73:193-8.
122. Norell M, Lythall D, Coghlan G, et al. Limited value of the resting electrocardiogram in assessing patients with recent onset chest pain: lessons from a chest pain clinic. Br Heart J 1992;67:53-6.
123. Bobbio M, Fubini A, Detrano R, et al. Diagnostic accuracy of predicting coronary artery disease related to patients' characteristics. J Clin Epidemiol 1994;47:389-95.
124. Davie AP, Caesar D, Caruana L, et al. Outcome from a rapid-assessment chest pain clinic. QJM 1998;91:339-43.
125. Duncan B, Fulton M, Morrison SL, et al. Prognosis of new and worsening angina pectoris. BMJ 1976;1:981-5.
126. Lampe FC, Whincup PH, Wannamethee SG, Shaper AG, Walker M, Ebrahim S. The natural history of prevalent ischaemic heart disease in middle-aged men. Eur Heart J 2000;21:1052-62.
127. Byrne J, Murdoch D, Morrison C, McMurray J. An audit of activity and outcome from a daily and a weekly 'one stop' rapid assessment chest pain clinic. Postgrad Med J 2002;78:43-6.
128. Paul VE, Sulke AN, Norris AD. Open access exercise electrocardiography: does it improve the management of cardiovascular disease in the community? J R Soc Med 1990;83:143-5.
129. McClements BM, Campbell NP, Cochrane D, Stockman S. Direct access exercise electrocardiography: a new service that improves the management of suspected ischaemic heart disease in the community. Br Heart J 1994; 71:531-5.
130. Farkouh ME, Smars PA, Reeder GS, et al. A clinical trial of a chest-pain observation unit for patients with unstable angina. Chest Pain Evaluation in the Emergency Room (CHEER) Investigators. N Engl J Med 1998;339:1882-8.
131. Fitzpatrick R. Telling patients there is nothing wrong. BMJ 1996;313:311-12.
132. Wood DA, Fox KF, Gibbs SR. Rapid cardiology - for chest pain, breathlessness and palpitations. QJM 2001;94:177-8.
133. Buclin T, Van Melle G, Haller E, Yersin B, Berger JP. Diagnosis, clinical presentation and triage criteria of emergency patients admitted for chest pain: prospective study of 278 cases. Schweiz Med Wochenschr; J SuisseMed 1988;118:1921-5 (in French).
134. Craig IH. Accuracy of hospital diagnosis of myocardial infarction. Aust N Z J Med 1982; 12:14-18.
135. Tierney WM, Roth BJ, Psaty B, et al. Predictors of myocardial infarction in emergency room patients. Crit Care Med 1985;13:526-31.
136. Bertini G, Rostagno C, Taddei T, et al. Evaluation of a mobile coronary care unit protocol in patients with acute onset chest pain. J Emerg Med 1991;9 Suppl 1:57-63.
137. Gama R, Swain DG, Nightingale PG, Buckley BM. The effective use of cardiac enzymes and electrocardiograms in the diagnosis of acute myocardial infarction in the elderly. Postgrad Med J 1990;66:375-7.
138. Hedges JR, Young GP, Henkel GF, Gibler WB, Green TR, Swanson JR. Serial ECGs are less accurate than serial CK-MB results for emergency department diagnosis of myocardial infarction. Ann Emerg Med 1992;21:1445-50.
139. Sgarbossa EB, Pinski SL, Barbagelata A, et al. Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators [published erratum appears in N Engl J Med 1996;334:931]. N Engl J Med 1996;334:481-7.
140. Shlipak MG, Lyons WL, Go AS, Chou TM, Evans GT, Browner WS. Should the electrocardiogram be used to guide therapy for patients with left bundle-branch block and suspected myocardial infarction? JAMA 1999;281:714-19.
141. Tighe M, Kellett J, Corry R, Reddan E, Ryan B. The early diagnosis of acute myocardial infarction. Comparison of a simple algorithm with a computer program for electrocardiogram interpretation. Ir J Med Sci 1996;165:159-63.
142. Acanfora D, De Caprio L, Di Palma A, et al. Exercise induced increase in diastolic blood pressure. Is it an indicator of coronary artery disease? Eur Heart J 1991;12:1195-7.
143. Alexander KP, Shaw LJ, Shaw LK, Delong ER, Mark DB, Peterson ED. Value of exercise treadmill testing in women [published erratum appears in J Am Coll Cardiol 1999;33:289]. J Am Coll Cardiol 1998;32:1657-64.
144. Alijarde-Guimera M, Evangelista A, Galve E, Olive S, Anivarro I, Soler-Soler J. Useless diagnostic value of exercise-induced R wave changes in coronary artery disease. Eur Heart J 1983;4:614-21.
145. Aparici M, Barba J, Peteiro J, Hidalgo R, Sanz P, Castello R. Sensitivity and specificity of the exertion test in elderly patients. Med Clin (Barc) 1989;93:321-4 (in Spanish).
146. Ascoop CA, Simoons ML, Egmond WG, Bruschke AV. Exercise test, history, and serum lipid levels in patients with chest pain and normal electrocardiogram at rest: comparison to findings at coronary arteriography. Am Heart J 1971; 82:609-17.
147. Atwood JE, Do D, Froelicher V, et al. Can computerization of the exercise test replace the cardiologist? Am Heart J 1998;136:543-52.
148. Balnave K, Scott ME, Morton P, Murtagh JG. Reliable prediction of coronary disease using treadmill exercise testing. BMJ 1978;1:958-9.
149. Baron DW, Poole-Wilson PA, Rickards AF. Maximal 12-lead exercise testing for prediction of severity of coronary artery disease. Eur J Cardiol 1980; 11:259-67.
150. Barthelemy J-C, Roche F, Gaspoz J-M, et al. Maximal blood lactate level acts as a major discriminant variable in exercise testing for coronary artery disease detection in men. Circulation 1996;93:246-52.
151. Berman JL, Wynne J, Cohn PF. Multiple-lead QRS changes with exercise testing. Diagnostic value and hemodynamic implications. Circulation 1980; 61:53-61.
152. Bonoris PE, Greenberg PS, Castellanet MJ, Ellestad MH. Significance of changes in R wave amplitude during treadmill stress testing: angiographic correlation. Am J Cardiol 1978; 41:846-51.
153. Bungo MW, Leland OS Jr. Discordance of exercise thallium testing with coronary arteriography in patients with atypical presentations. Chest 1983; 83:112-16.
154. Campos CT, Chu HW, D'Agostino HJJ, Jones RH. Comparison of rest and exercise radionuclide angiocardiography and exercise treadmill testing for diagnosis of anatomically extensive coronary artery disease. Circulation 1983;67:1204-10.
155. Cantor A, Goldfarb B, Mai O, Battler A. Ischemia detection in women: the diagnostic value of exercise QRS duration changes. J Electrocardiol 1998;31:271-7.
156. Chaitman BR, Bourassa MG, Wagniart P, Corbara F, Ferguson RJ. Improved efficiency of treadmill exercise testing using a multiple lead ECG system and basic hemodynamic exercise response. Circulation 1978;57:71-9.
157. Cheng SL, Ellestad MH, Selvester RH. Significance of ST-segment depression with R-wave amplitude decrease on exercise testing. Am J Cardiol 1999;83:955-9.
158. Chikamori T, Yamada M, Takata J, et al. Diagnostic significance of exercise-induced ST-segment depression in the inferior leads in patients with suspected coronary artery disease. Am J Cardiol 1994;74:1161-4.
159. Chikamori T, Hirakawa K, Seo H, et al. Diagnostic significance of exercise-induced ST-segment depression in the lateral limb leads in patients with suspected coronary artery disease. Am J Cardiol 1995;76:513-16.
160. Ciaroni S, Bloch A, Cuenoud L, Fournet PC. Clinical value of measuring systolic arterial blood pressure post-exercise for evaluation and diagnosis of coronary disease: comparative study between women and men. Schweiz Med Wochenschr; J Suisse Med 1998;128:400-8 (in French).
161. Currie PJ, Kelly MJ, Harper RW, et al. Incremental value of clinical assessment, supine exercise electrocardiography, and biplane exercise radionuclide ventriculography in the prediction of coronary artery disease in men with chest pain. Am J Cardiol 1983;52:927-35.
162. Curzen N, Patel D, Clarke D, et al. Women with chest pain: is exercise testing worthwhile? Heart 1996;76:156-60.
163. Demange J, Herpin D, Gaudeau B, et al. Improvement of the diagnostic value of exercise test by heart-rate adjusted segment depression. Value of ST 20/HR index. Arch Mal Coeur Vaiss 1992;85:175-81 (in French).
164. Detrano R, Yiannikas J, Salcedo EE, et al. Bayesian probability analysis: a prospective demonstration of its clinical utility in diagnosing coronary disease. Circulation 1984;69:541-7.
165. Detrano R, Salcedo E, Passalacqua M, Friis R. Exercise electrocardiographic variables: a critical appraisal. J Am Coll Cardiol 1986;8:836-47.
166. Detrano R, Salcedo E, Leatherman J, Day K. Computer-assisted versus unassisted analysis of the exercise electrocardiogram in patients without myocardial infarction. J Am Coll Cardiol 1987;10:794-9.
167. Detry JM, Kapita BM, Cosyns J, Sottiaux B, Brasseur LA, Rousseau MF. Diagnostic value of history and maximal exercise electrocardiography in men and women suspected of coronary heart disease. Circulation 1977;56:756-61.
168. Detry JM, Beauthier-Muschart E, Rousseau M, Cosyns J, Brasseur L. Influence of resting ECG abnormalities on the ECG response to maximal exercise in women suspected of coronary heart disease. Acta Cardiol 1978;33:305-13.
169. Dressendorfer RH, Chong-Xuan G, Timmis GC. A simple procedure for improving treadmill test sensitivity in beta blockade. J Cardiopulm Rehabil 1989;9:341-7.
170. Egloff C, Merola P, Schiavon C, et al. Sensitivity, specificity and predictive accuracy of Q wave, QX/QT ratio, QTc interval and ST depression during exercise testing in men with coronary artery disease. Am J Cardiol 1987;60:1006-8.
171. Froelicher VF, Lehmann KG, Thomas R, et al. The electrocardiographic exercise test in a population with reduced workup bias: diagnostic performance, computerized interpretation, and multivariable prediction. Veterans Affairs Cooperative Study in Health Services:016 (QUEXTA) Study Group. Quantitative Exercise Testing and Angiography. Ann Intern Med 1998;128:965-74.
172. 201thallium scanning in the diagnosis of myocardial ischemia and coronary artery disease. Comparison with exercise and rest electrocardiography, coronary arteriography and left ventriculography. Chest 1980;77:359-68.
173. Helfant RH, Banka VS, DeVilla MA, Pine R, Kabde V, Meister SG. Use of bicycle ergometry and sustained handgrip exercise in the diagnosis of presence and extent of coronary heart disease. Br Heart J 1973;35:1321-5.
174. Herpin D, Ferrandis J, Borderon P, et al. Comparison of the diagnostic accuracy of different methods of measurement of heart rate-adjusted ST-segment depression during exercise testing for identification of coronary artery disease. Am J Cardiol 1995;76:1147-51.
175. Herpin D, Ferrandis J, Couderq C, et al. Usefulness of a quantitative analysis of the recovery phase patterns of the ST-segment depression in the diagnosis of coronary artery disease. Am J Med 1996;101:592-8.
176. Herpin D, Couderq C, Demange J. Assessment of the presence and severity of coronary artery disease in symptomatic patients, using stepwise discriminant analysis of computerized exercise and recovery data. J Noninvas Cardiol 1998;2:7-14.
177. Hoberg E, Kunze B, Konig J, Kabel Y, Kubler W. The noninvasive diagnosis of coronary heart disease in women. The exercise ECG or ST-segment analysis in the long-term ECG?. Dtsch Med Wochenschr 1991;116:441-6 (in German).
178. Ibrahim NS, Abboud G, Selvester RS, Hagar JM, Ellestad MH. Detecting exercise-induced ischemia in left bundle branch block using the electrocardiogram [published erratum appears in Am J Cardiol 1999;83:142]. Am J Cardiol 1998; 82:832-5.
179. Ilsley C, Canepa-Anson R, Westgate C, Webb S, Rickards A, Poole W. Influence of R wave analysis upon diagnostic accuracy of exercise testing in women. Br Heart J 1982;48:161-8.
180. Jelinkova A, Hlinomaz O. New indexes in the diagnostics of coronary artery disease in females by means of exercise ECG. Scr Med Fac Med Univ Brun Masarykianae 1997;70:45-50.
181. Kajinami K, Seki H, Takekoshi N, Mabuchi H. Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography: comparison with electrocardiographic and thallium exercise stress test results. J Am Coll Cardiol 1995;26:1209-21.
182. Kisacik HL, Ozdemir K, Altinyay E, et al. Comparison of exercise stress testing with simultaneous dobutamine stress echocardiography and technetium-99m isonitrile single-photon emission computerized tomography for diagnosis of coronary artery disease. Eur Heart J 1996; 17:113-19.
183. Kramer N, Susmano A, Shekelle RB. The 'false negative' treadmill exercise test and left ventricular dysfunction. Circulation 1978;57:763-8.
184. Lachterman B, Lehmann KG, Abrahamson D, Froelicher VF. 'Recovery only' ST-segment depression and the predictive accuracy of the exercise test [published erratum appears in Ann Intern Med 1990;113:333-4]. Ann Intern Med 1990;112:11-16.
185. Lachterman B, Froelicher VF. Do recovery ST-segment shifts affect the predictive accuracy of exercise testing? Cardiol Board Rev 1991;8:57-71.
186. Liu YB, Huang PJ, Su CT, Chieng PU, Wu CC, Ho YL. Comparison of S-T segment/heart rate slope with exercise thallium imaging and conventional S-T segment criteria in detecting coronary artery disease: effect of exercise level on accuracy. Cardiology 1998;89:229-34.
187. Lu ZY, Haus S. Evaluation of exercise-induced QRS amplitude changes (Athens score) and their clinical value. J Tongji Med Univ 1993;13:177-82.
188. Macieira-Coelho E, Oliveira MF, Turkman MA. Diagnosis of ischemic cardiopathy in ambulatory care patients. Multivariate analysis of clinical and electrocardiographic data. Acta Med Port 1990; 3:277-82 (in Portuguese).
189. Malczewska B, Szwed H, Kowalik I, Wiernikowski A, Sadowski Z, Kornacewicz-Jach Z. The diagnostic value of ECG stress test in premenopausal females with chest pain. Kardiol Pol 1999;50:1-12.
190. Marcomichelakis J, Donaldson R, Green J, et al. Exercise testing after beta-blockade: improved specificity and predictive value in detecting coronary heart disease. Br Heart J 1980;43:252-61.
191. McNeer JF, Margolis JR, Lee KL, et al. The role of the exercise test in the evaluation of patients for ischemic heart disease. Circulation 1978;57:64-70.
192. Melendez LJ, Driedger AA, Salcedo JR, Jones DT, MacDonald AC. Exercise electrocardiography and myocardial perfusion imaging in the diagnosis of coronary artery disease: preliminary report. Can J Surg 1979;22:334-6.
193. Melin JA, Wijns W, Vanbutsele RJ, et al. Alternative diagnostic strategies for coronary artery disease in women: demonstration of the usefulness and efficiency of probability analysis. Circulation 1985; 71:535-42.
194. Michaelides AP, Triposkiadis FK, Boudoulas H, et al. New coronary artery disease index based on exercise-induced QRS changes. Am Heart J 1990; 120:292-302.
195. Michaelides AP, Psomadaki ZD, Dilaveris PE, et al. Improved detection of coronary artery disease by exercise electrocardiography with the use of right precordial leads. N Engl J Med 1999;340:340-5.
196. Moons KG, van Es GA, Deckers JW, Habbema JD, Grobbee DE. Limitations of sensitivity, specificity, likelihood ratio, and bayes' theorem in assessing diagnostic probabilities: a clinical example. Epidemiology 1997;8:12-17.
197. Morise AP, Duval RD. Accuracy of ST/heart rate index in the diagnosis of coronary artery disease. Am J Cardiol 1992;69:603-6.
198. Morise AP, Diamond GA, Detrano R, Bobbio M. Incremental value of exercise electrocardiography and thallium-201 testing in men and women for the presence and extent of coronary artery disease. Am Heart J 1995;130:267-76.
199. Morise AP, Duval RD. Diagnostic accuracy of heart rate-adjusted ST segments compared with standard ST-segment criteria. Am J Cardiol 1995; 75:118-21.
200. Morise AP, Diamond GA. Comparison of the sensitivity and specificity of exercise electrocardiography in biased and unbiased populations of men and women. Am Heart J 1995; 130:741-7.
201. Morris SN, Phillips JF, Jordan JW, McHenry PL. Incidence and significance of decreases in systolic blood pressure during graded treadmill exercise testing. Am J Cardiol 1978;41:221-6.
202. Nair CK, Aronow WS, Sketch MH, et al. Diagnostic and prognostic significance of exercise-induced premature ventricular complexes in men and women: a four year follow-up. J Am Coll Cardiol 1983;1:1201-6.
203. Nallamothu N, Ghods M, Heo J, Iskandrian AS. Comparison of thallium-201 single-photon emission computed tomography and electrocardiographic response during exercise in patients with normal rest electrocardiographic results. J Am Coll Cardiol 1995;25:830-6.
204. Nasrallah AT, Garcia E, Benry J, Hall RJ. Treadmill exercise testing in the presence of digitals therapy or nonspecific ST-T changes: correlation with coronary angiography. Catheter Cardiovasc Diagn 1975;1:375-80.
205. Newman GF, Rerych SK, Upton MT, Sabiston DC Jr, Jones RH. Comparison of electrocardiographic and left ventricular functional changes during exercise. Circulation 1980;62:1204-11.
206. Newman KP, Phillips JH. Graded exercise testing for diagnosis of coronary artery disease in elderly patients. South Med J 1988;81:430-2.
207. Oguzhan A, Kisacik HL, Ozdemir K, et al. Comparison of exercise stress testing with dobutamine stress echocardiography and exercise technetium-99m isonitrile single photon emission computerized tomography for diagnosis of coronary artery disease. Jpn Heart J 1997; 38:333-44.
208. Okin PM, Kligfield P. Population selection and performance of the exercise ECG for the identification of coronary artery disease. Am Heart J 1994;127:296-304.
209. Paillole C, Ruiz J, Juliard JM, Leblanc H, Gourgon R, Passa P. Detection of coronary artery disease in diabetic patients. Diabetologia 1995; 38:726-31.
210. Papazoglou N, Stagou M, Gionakis G, et al. Post-exercise response of the systolic blood pressure in the diagnosis of coronary artery disease: comparison of two exercise methods. Int J Cardiol 1991;30:297-302.
211. Patterson RE, Horowitz SF, Eng C. Can exercise electrocardiography and thallium-201 myocardial imaging exclude the diagnosis of coronary artery disease? Bayesian analysis of the clinical limits of exclusion and indications for coronary angiography. Am J Cardiol 1982;49:1127-35.
212. Piessens J, Van Mieghem W, Kesteloot H, De Geest H. Diagnostic value of clinical history, exercise testing and atrial pacing in patients with chest pain. Am J Cardiol 1974;33:351-6.
213. Pruvost P, Lablanche JM, Beuscart R, et al. Enhanced efficacy of computerized exercise test by multivariate analysis for the diagnosis of coronary artery disease. A study of 558 men without previous myocardial infarction. Eur Heart J 1987;8:1287-94.
214. Quyyumi AA, Raphael MJ, Wright C, Bealing L, Fox KM. Inability of the ST segment/heart rate slope to predict accurately the severity of coronary artery disease. Br Heart J 1984;51:395-8.
215. Rijneke RD, Ascoop CA, Talmon JL. Clinical significance of upsloping ST segments in exercise electrocardiography. Circulation 1980;61:671-8.
216. Ritchie JL, Trobaugh GB, Hamilton GW, et al. Myocardial imaging with thallium-201 at rest and during exercise. Comparison with coronary arteriography and resting and stress electrocardiography. Circulation 1977;56:66-71.
217. Rodriguez M, Moussa I, Froning J, Kochumian M, Froelicher VF. Improved exercise test accuracy using discriminant function analysis and 'recovery ST slope'. J Electrocardiol 1993;26:207-18.
218. Roitman D, Jones WB, Sheffield LT. Comparison of submaximal exercise ECG test with coronary cineangiocardiogram. Ann Intern Med 1970;72:641-7.
219. Rowe DW, Oquendo I, DePuey EG. The noninvasive diagnosis of coronary artery disease in patients with left bundle-branch block. Tex Heart Instit J 1982;9:397-406.
220. Salazar E, Lara MA, Gil M, Martinez-Rios MA. Correlation between exercise test and coronariography. Arch Inst Cardiol Mex 1976;46:707-19 (in Spanish).
221. San Roman JA, Vilacosta I, Castillo JA, et al. Selection of the optimal stress test for the diagnosis of coronary artery disease. Heart 1998; 80:370-6.
222. Santinga JT, Flora J, Maple R, Brymer JF, Pitt B. The determination of the post-test likelihood for coronary disease using Bayes theorem. J Electrocardiol 1982;15:61-8.
223. Santoro GM, Sciagra R, Buonamici P, et al. Head-to-head comparison of exercise stress testing, pharmacologic stress echocardiography, and perfusion tomography as first-line examination for chest pain in patients without history of coronary artery disease. J Nucl Cardiol 1998:5:19-27.
224. Sato I, Keta K, Aihara N, Ohe T, Shimomura K, Hasegawa Y. Improved accuracy of the exercise electrocardiogram in detection of coronary artery and three-vessel coronary disease. Chest 1988;94:737-44.
225. Silverberg RA, Diamond GA, Vas R, Tzivoni D, Swan HJ, Forrester JS. Noninvasive diagnosis of coronary artery disease: the cardiokymographic stress test. Circulation 1980;61:579-89.
226. Sketch MH, Mohiuddin SM, Lynch JD, Zencka AE, Runco V. Significant sex differences in the correlation of electrocardiographic exercise testing and coronary arteriograms. Am J Cardiol 1975;36:169-73.
227. Sullivan AK, Holdright DR, Wright CA, Sparrow JL, Cunningham D, Fox KM. Chest pain in women: clinical, investigative, and prognostic features. BMJ 1994;308:883-6.
228. Thwaites BC, Quyyumi AA, Raphael MJ, Canepa-Anson R, Fox KM. Comparison of the ST/heart rate slope with the modified Bruce exercise test in the detection of coronary artery disease. Am J Cardiol 1986;57:554-6.
229. Tsuda M, Hatano K, Hayashi H, Yokota M, Hirai M, Saito H. Diagnostic value of postexercise systolic blood pressure response for detecting coronary artery disease in patients with or without hypertension. Am Heart J 1993;125:718-25.
230. Tucker SC, Kemp VE, Holland WE, Horgan JH. Multiple lead ECG submaximal treadmill exercise tests in angiographically documented coronary heart disease. Angiology 1976;27:149-56.
231. Turner AS, Nathan MC, Watson OF, Brocklehurst J, Langley RB, Spence RJ. The correlation of the computer quantitated treadmill exercise electrocardiogram with cinearteriographic assessment of coronary artery disease. N Z Med J 1979;89:115-18.
232. Vovan A, Tribouilloy C, Avinee P, Lecuyer D, Dericbourg C, Lesbre JP. Value of the negative U wave during exercise test in the diagnosis of coronary insufficiency. Arch Mal Coeur Vaiss 1987; 80:52-8 (in French).
233. Walling AD, Crawford MH. Exercise testing in women with chest pain: applications and limitations of computer analysis. Coron Artery Dis 1993;4:783-9.
234. Weiner DA, Ryan TJ, McCabe CH, et al. Exercise stress testing. Correlations among history of angina, ST-segment response and prevalence of coronary-artery disease in the country artery surgery study (CASS). N Engl J Med 1979; 301:230-5.
235. Weintraub WS, Madeira SWJ, Bodenheimer MM, et al. Critical analysis of the application of Bayes' theorem to sequential testing in the noninvasive diagnosis of coronary artery disease. Am J Cardiol 1984;54:43-9.
236. Weintraub WS, Barr-Alderfer VA, Seelaus PA, et al. A sequential approach to the diagnosis of coronary artery disease using multivariate analysis. Am Heart J 1985;109:999-1005.
237. Wetherbee JN, Bamrah VS, Ptacin MJ, Kalbfleisch JH. Comparison of ST segment depression in upright treadmill and supine bicycle exercise testing. J Am Coll Cardiol 1988;11:330-7.
238. Wilson RA, Bamrah VS, Lindsay JJ, Schwaiger M, Morganroth J. Diagnostic accuracy of seismocardiography compared with electrocardiography for the anatomic and physiologic diagnosis of coronary artery disease during exercise testing. Am J Cardiol 1993; 71:536-45.
239. Jelinek VM, Herman MV, Schweitzer P, Gorlin R. The significance of chest pain occurring with the Master two step test. Aust N Z J Med 1976;6:22-5.
240. Joswig BC, Glover MU, Nelson DP, Handler JB, Henderson J. Analysis of historical variables, risk factors and the resting electrocardiogram as an aid in the clinical diagnosis of recurrent chest pain. Comput Biol Med 1985;15:71-80.
241. McGowan RL, Martin ND, Zaret BL, et al. Diagnostic accuracy of noninvasive myocardial imaging for coronary artery disease: an electrocardiographic and angiographic correlation. Am J Cardiol 1977;40:6-10.
242. Moussa I, Rodriguez M, Froning J, Froelicher VF. Prediction of severe coronary artery disease using computerized ECG measurements and discriminant function analysis. J Electrocardiol 1992;25 Suppl:49-58.
243. Murray RG, Lorimer AR, Dunn FG, Macfarlane PW, Hutton I, Lawrie TD. Comparison of 12-lead and computer-analysed 3 orthogonal lead electrocardiogram in coronary artery disease. Br Heart J 1976;38:773-8.
244. Riecansky I, Ruttkay-Nedecky I, Havlinova K, Zelenay J, Misekova J. Comparison of echocardiography, vectorcardiography, electrocardiography, coronarography and ventriculography in coronary heart disease. Acta Cardiol 1988;43:309-14.