Author Affiliations: Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md.
Identification of individuals at high risk for coronary events is a growing concern,
reflecting increasing confidence in the capability of mechanical and
pharmacological interventions to improve the outlook for coronary
atherosclerosis. Numerous prognostic indicators have been proposed.
Recently, physicians and the lay public have been inundated by
advertisements for new tests aimed at identifying or excluding high
coronary risk, with an implicit promise of a longer, better, less
anxious life as the ultimate payoff.1,2 Validation of
prognostic indices with a full understanding of their appropriate
context and their implications for patient management are vitally
important in formulating effective and efficient strategies for patient
care. Inappropriate application of prognostic indices can lead to
excessive use of costly and potentially injurious tests and therapies
as well as needless patient anxiety.3,4
Goldstein RE, Holmboe ES. Prognostic Indicators for Coronary Artery DiseaseReady for the Bedside?. JAMA. 1999;281(6):565-566. doi:10.1001/jama.281.6.565