Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
To the Editor: Dr Gill and colleagues have
offered a set of recommendations regarding exercise stress testing for older
persons prior to starting an exercise program.1
However, in our litigious society, physicians may be reluctant to suggest
an exercise program without prior exercise stress testing. An additional problem
may be a high rate of false-positive exercise stress test results, which will
then require coronary arteriograms with more expense and risk.2
This may a significant problem in a population with a somewhat lower incidence
of significant coronary artery disease, if the concept of the Bayes theorem
is considered. More research is needed concerning the precise incidence of
false-positive stress test results in older individuals without clear evidence
of symptomatic coronary artery disease.
Finestone AJ. Exercise Stress Testing for Older Persons Starting an Exercise Program. JAMA. 2000;284(20):2591. doi:10.1001/jama.284.20.2591
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