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To the Editor:—
We read with interest the excellent paper, "Master Two-Step Exercise Test in Clinically Unselected Patients," by Dr. A. J. Brody, in The Journal, Oct. 31, page 1195. Brody's major conclusions deserve comment and, perhaps, amplification. It is gratifying that the value of a negative double two-step test result has again been demonstrated. In our experience, and that of other investigators, notably Robb and others (Tr. A. Life Insurance M. Dir. America40:52,1956) and Mattingly and others (Research Report 75-57, Walter Reed Army Institute of Research [May] 1957), a negative Master test practically, although not infallibly, excludes a diagnosis of myocardial ischemia at the time of testing. Brody's finding, that only 4.2% of his negative reactors subsequently developed coronary disease, closely parallels our own reports (Master: Proceedings of the Third World Congress of Cardiology, Brussels, 1958, p. 138; Master and others: Advances in Cardiology, New York, 1959,
Master AM, Rosenfeld I. MASTER TWO-STEP EXERCISE TEST. JAMA. 1960;172(3):265-266. doi:10.1001/jama.1960.03020030059018