Scientist-led Exercise Testing Is Safe With Diagnostic Interpretation Equivalent to a Cardiologist.
Crit Pathw Cardiol
; 19(1): 14-17, 2020 03.
Article
em En
| MEDLINE
| ID: mdl-31490210
ABSTRACT
BACKGROUND:
The implementation of nonphysician-led exercise stress testing (EST) has increased over the last 30 years, with endorsement by many cardiovascular societies around the world. The comparable safety of nonphysician-led EST to physician-led studies has been demonstrated, with some studies also showing agreement in diagnostic preliminary interpretations.OBJECTIVE:
The study aim was to firstly confirm the safety of nonphysician-led EST in a large cohort and secondly compare the interobserver agreement and diagnostic accuracy of cardiac scientist and junior medical officer (JMO)-led EST reports to cardiology consultant overreads.METHODS:
All ESTs performed between 1/7/2010 and 30/6/2013 were included in the study for JMO led tests (n = 1332). ESTs performed for the investigation of coronary artery disease between 1/7/2013 and 30/6/2016 were included for scientist-led testing (n = 1904).RESULTS:
There was one adverse event, an ST segment myocardial infarction during the recovery phase of a JMO-led EST. Interobserver agreement was superior between the cardiologist and the scientist compared with the cardiologist and the JMO (P < 0.0001). Sensitivity for JMO-led tests differed from the cardiologist overread (86.96% vs. 96.77%, P = 0.03). There were no other significant differences between the cardiologist overread and the JMO- or scientist-led interpretation.CONCLUSIONS:
Scientist-led EST is safe in intermediate risk patients and their preliminary reports are equally diagnostic as cardiologist overreads. While JMO-led ESTs are just as safe, the preliminary reports differ significantly from cardiologist overread particularly with respect to sensitivity.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Pessoal de Saúde
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Teste de Esforço
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Segurança do Paciente
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Cardiologistas
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Corpo Clínico Hospitalar
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article