Results of a routine exercise treadmill testing strategy early after percutaneous transluminal coronary angioplasty.
Bibliographic record
Abstract
BACKGROUND: Some physicians use routine exercise treadmill testing early after percutaneous transluminal coronary angioplasty (PTCA), yet there have been few prospective studies examining the results of such a functional testing strategy. OBJECTIVES: To examine the results of a routine post-PTCA exercise treadmill testing strategy, and to explore the impact of such a strategy on follow-up functional tests and cardiac procedures. PATIENTS AND METHODS: Functional test results were examined from a cohort of 226 patients who underwent PTCA at a single institution in which a routine functional testing strategy is used. Tests were defined as 'routine' if they were performed solely because the patient had a prior PTCA. Tests were defined as 'selective' if they were done for a clinical indication or if there was no functional testing during the six-month follow-up. RESULTS: A total of 183 patients (81%) underwent at least one functional test during the six-month period after PTCA. Of these patients, 150 (82%) underwent routine functional testing, the majority (73%) of which were exercise treadmill tests. Sixty-seven per cent of patients who had routine functional testing had their first functional test less than seven weeks after their PTCA. Most routine exercise treadmill tests were found to be electrically or clinically indeterminate (46%), but a substantial number were either electrically or clinically positive (28%), or electrically and clinically negative (39%). Of patients who had electrically or clinically positive routine tests, 57% had repeat functional testing and 23% had repeat revascularization. Of patients who had electrically and clinically negative tests, 53% had repeat functional testing and 10% had repeat revascularization. Of the patients who had electrically or clinically indeterminate tests, 53% had repeat functional testing and 14% had repeat revascularization. The rate of clinical events was less than 4%, irrespective of the results of the exercise treadmill tests. CONCLUSIONS: Routine exercise treadmill testing early after PTCA is associated with a low clinical yield. Most routine exercise treadmill testing results in indeterminate and negative tests, which often lead to more functional tests with little difference in clinical outcome. These results call into question the use of a routine post-PTCA functional testing strategy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".