Document Detail


Is an exercise tolerance test indicated before beginning regular exercise? A decision analysis.
MedLine Citation:
PMID:  19506973     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Dror Lahav; Moshe Leshno; Mayer Brezis
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of general internal medicine     Volume:  24     ISSN:  1525-1497     ISO Abbreviation:  J Gen Intern Med     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-15     Completed Date:  2010-03-29     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  8605834     Medline TA:  J Gen Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  934-8     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine E, Tel-Aviv Sourasky Medical Center, Ichilov Hospital, Tel-Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Coronary Disease / complications,  physiopathology,  prevention & control
Death, Sudden, Cardiac / prevention & control
Decision Support Techniques*
Exercise* / physiology
Exercise Test / methods*,  statistics & numerical data*
Exercise Tolerance* / physiology
Humans
Monte Carlo Method
Physical Fitness / physiology
Risk Factors
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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