Each year hundreds of thousands of Americans, including some 700,000 Medicare recipients, get on a treadmill not for exercise but to try to determine if their hearts are healthy.
Tim Russert, the NBC journalist, had such an exam, called an exercise or treadmill stress test, six weeks before he died of a heart attack last month at age 58. His results had been deemed normal, prompting people to question how worthwhile this test could be.
Two weeks before Russert died, Todd Miller, a cardiologist and co-director of the Mayo Clinic's Nuclear Cardiology Laboratory in Rochester, Minnesota, published an assessment of the test's ability to predict the presence of potentially life-threatening cardiac problems. Miller elaborated on his report, in The Cleveland Clinic Journal of Medicine, in a telephone interview.
The test is meant to be used "almost exclusively" for people who have symptoms of heart disease, Miller emphasized.
"But in the real world," he said, "it is often used as a screening test for people without symptoms who are worried about their risk. The accuracy of the test depends on whom it is used. It is most accurate among populations with a high prevalence of coronary disease. But in most people without symptoms, the prevalence of disease is so low that the accuracy of the test is low, too
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