RT Journal
A1 Floyd JL
T1 EXercise testing
JF JAMA
JO JAMA
YR 1979
FD September 21
VO 242
IS 12
SP 1259
OP 1259
DO 10.1001/jama.1979.03300120013010
UL http://dx.doi.org/10.1001/jama.1979.03300120013010
AB To the Editor.— 
    In the report by Hartley et al (241:269, 1979), a program of exercise testing was described that would be suited to serve large numbers of people economically. While much useful information may be gleaned from a properly performed stress ECG in selected patients, its use as a primary screening tool is subject to criticism. A screening test must have extreme sensitivity with acceptable specificity and be relatively inexpensive. While in a select group of subjects (patients who sought medical care because of chest pain) the specificity of the stress ECG is high (88% to 97%), its sensitivity is low (54% to 80%).1-5 Thus, the predictive value of the test in a population with a low prevalence of "coronary disease-free" would be poor. It is therefore unlikely that the benefit to society of mass application of stress electrocardiography would parallel the reduction in cost of the procedure.