Diagnostic characteristics and prognoses of primary-care patients referred for clinical exercise testing: a prospective observational study

Table 5 Composite diagnostic characteristics of exercise test outcome (positive/non-conclusive tests)

Characteristic	Exertional chest pain* and pathologic ST-T segment**	Exertional chest pain and angina diagnosis according to patient’s opinion^†	Exertional chest pain and pathologic ST-T segment and angina diagnosis according to patient’s opinion
Characteristic	(95% CI)	(95% CI)	(95% CI)
Number of patients with characteristic	26	74	15
Sensitivity	37.1% (26.8-48.9)	58.3% (49.6-66.5)	28.3% (18.0-41.6)
Specificity	92.5% (89.3-94.8)	78.5% (74.2-82.2)	96.6% (93.9-98.1)
Positive predictive value	59.9% (48.2-70.5)	45.0% (39.2-50.9)	71.5% (54.8-83.9)
Negative predictive value	83.0% (80.2-85.4)	86.2% (83.4-88.5)	81.7% (79.0-84.1)
Likelihood ratio for positive test	4.9 (3.1-7.9)	2.7 (2.1-3.4)	8.3 (4.0-18.0)
Likelihood ratio for negative test	0.7 (0.6-0.8)	0.5 (0.4-0.7)	0.7 (0.6-0.9)
Pre-test probability of having a positive/non-conclusive exercise test	23.2%	23.2%	23.2%
Net gain after positive result	36.7% (25.0-47.3)	21.8% (16.0-27.7)	48.3% (31.6-60.7)
Number of patients with characteristic per positive/non-conclusive exercise test	1.7	2.2	1.4

*Chest pain when walking uphill or in a hurry. **Pathologic ST-T segment on resting electrocardiogram. ^†Patient’s opinion of angina diagnosis: yes or no. CI: confidence interval. Positive exercise test: angina symptoms and ST-segment depression >0.1 mV during the test. Non-conclusive test: angina or ST depression. Negative test: neither angina nor ST depression.

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