Document Detail

The effect of validation group bias on screening tests for coronary artery disease.
MedLine Citation:
PMID:  3992074     Owner:  NLM     Status:  MEDLINE    
The exercise electrocardiogram (ECG) is frequently used as a screening tool for coronary artery disease (CAD) in epidemiological studies and routine health evaluation. Estimates of the validity of this diagnostic test have usually been obtained by correlating the exercise ECG with the results of coronary angiography. However, coronary angiography is usually performed only on selected individuals with symptomatic CAD. If symptomatic subjects are more likely to respond positively to the exercise ECG than asymptomatic individuals with comparable severity of disease, then biased estimates of the test validity for an unselected population may be obtained. In this paper the validation group bias is shown to be a function both of the proportion of the population with symptomatic CAD and of the relative validity of the test for the symptomatic and asymptomatic subjects. The extent of this bias is examined.
M S Green
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Statistics in medicine     Volume:  4     ISSN:  0277-6715     ISO Abbreviation:  Stat Med     Publication Date:    1985 Jan-Mar
Date Detail:
Created Date:  1985-06-11     Completed Date:  1985-06-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8215016     Medline TA:  Stat Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  53-61     Citation Subset:  IM    
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MeSH Terms
Coronary Angiography
Coronary Disease / diagnosis*,  radiography
Epidemiologic Methods
Exercise Test*
Statistics as Topic
Grant Support

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