|
The second step in
deciding which of two tests -- dobutamine echo or exercise ECG
-- is preferable, involves their application in clinical practice.
You must decide if the post-test probability would make a difference
in the treatment of the patient. Would you do anything differently
as a result of these findings?
| Table
1.10.1: Post-test Probabilities
|
|---|
|
| Dobutamine
echocardiogram
| Exercise
ECG
|
|---|
|
pre-test odds | 1
in 3 | 1
in 3 |
post-test
odds
| | |
test positive
| 1.50 | 1.00 |
| test
negative | 0.05 | 0.14 |
post-test
p[CAD]
| | |
| test
positive | 0.60
| 0.50 |
| test
negative | 0.04
| 0.12 |
|
Problem
1.10.1
Look at
the post-test probability after a positive test and think
how you would respond in the situations that follow.
Question 1.10.1.1
Would raising the probability
of disease from 0.25 to 0.60 alter your decision to treat the
patient with a beta-blocker?
 | Probably
yes |
 | Probably
no |
Question 1.10.1.2
Should raising the
probability of disease from 0.25 to 0.60 lead to further diagnostic
testing?
| Probably
yes |
| Probably
no |
|