| Is an exercise tolerance test indicated before beginning regular exercise? A decision analysis. | |
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MedLine Citation:
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PMID: 19506973 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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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Authors:
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Dror Lahav; Moshe Leshno; Mayer Brezis |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of general internal medicine Volume: 24 ISSN: 1525-1497 ISO Abbreviation: J Gen Intern Med Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-15 Completed Date: 2010-03-29 Revised Date: 2010-09-27 |
Medline Journal Info:
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Nlm Unique ID: 8605834 Medline TA: J Gen Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 934-8 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine E, Tel-Aviv Sourasky Medical Center, Ichilov Hospital, Tel-Aviv, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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