Sensitivity and Specificity of the History and Physical Examination for Coronary Artery Disease
Authors: Arthur T. Evans
Journal: Annals of Internal Medicine (1994)

Letters15 February 1994Sensitivity and Specificity of the History and Physical Examination for Coronary Artery DiseaseArthur T. Evans, MD, MPHArthur T. Evans, MD, MPHUniversity of North Carolina at Chapel Hill; Chapel Hill, NC 27599Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-4-199402150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Pryor and colleagues have written a very interesting article [1]; however, their data on sensitivity and specificity for each of the three diagnostic outcomes (significant disease, severe disease, and left main disease) are subject to verification or work-up bias. Their study sample included 1030 patients, but diagnostic outcomes were verified on only the 168 patients who subsequently had cardiac catheterization within 90 days. Because patients who “tested” positive (based on history and physical examination data) were more likely to have the gold standard evaluation (cardiac catheterization), the reported sensitivities are probably falsely high, and the reported specificities ...REFERENCE1. Pryor DB, Shaw L, McCants CB, Lee KL, Mark DB, Harrell FE Jr, et al. Value of the history and physical in identifying patients at increased risk for coronary artery disease. Ann Intern Med. 1993; 118:81-90. Google Scholar Author, Article, and Disclosure InformationAuthors: Arthur T. Evans, MD, MPHAffiliations: University of North Carolina at Chapel Hill; Chapel Hill, NC 27599 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe cardiovascular systemACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina11This document was approved by the American College of Cardiology Board of Trustees in March 1999, the American Heart Association Science Advisory and Coordinating Committee in March 1999, and the American College of Physicians-American Society of Internal Medicine Board of Regents in February 1999.When citing this document, please use the following citation format: Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, Grunwald MA, Levy D, Lytle BW, O’Rourke RA, Schafer WP, Williams SV. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 1999;33:2092–197.This document is available on the World Wide Web sites of the American College of Cardiology (www.acc.org) and the American Heart Association (www.americanheart.org). Reprints of this document are available by calling 1-800-253-4636 or writing the American College of Cardiology, Educational Services, at 9111 Old Georgetown Road, Bethesda, MD 20814-1699. Ask for reprint number 71-0166. To obtain a reprint of the Executive Summary and Recommendations published in the June 1, 1999 issue of Circulation, ask for reprint number 71-0167. To purchase bulk reprints (specify version and reprint number): Up to 999 copies call 1-800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies call 214-706-1466, fax 214-691-6342, or e-mail [email protected] 15 February 1994Volume 120, Issue 4Page: 344-345KeywordsCatheterizationPatientsSpecificityStable coronary artery disease ePublished: 15 August 2000 Issue Published: 15 February 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...