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Exercise Tolerance Test: The Decision to Refer
Ken Grauer, MD
Department of Health and Family Medicine College of Medicine, University of Florida Gainesville
Arch Fam Med. 1993;2(12):1221-1222.
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I read with interest the article by Hartz et al1 that appeared in the May issue of the ARCHIVES. The primary objective of the authors is laudable, namely, "to examine whether physician background and attitudes were related to the decision to refer a patient with chronic angina to a cardiologist following the results of an exercise tolerance test." Conclusions of the study are both eyeopening and bothersome, especially the facts that half the physicians queried did not alter their referral decision at all regarding the need for catheterization on the basis of exercise tolerance test (ETT) results and that the most important factor affecting physician decision making in the study was concern about lawsuits. Unfortunately, a fundamental fault in study methodology precludes drawing any additional conclusions.
Results of this study are based on a questionnaire circulated to internists and family physicians regarding the management of a hypothetical patient with
. . . [Full Text PDF of this Article]
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