A critique: coronary disease and exercise stress tests.

The exercise stress test is evaluated in terms of epidemiological criteria including validity, reliability, safety, rapidity, cost, yield, and acceptability. Rigid criteria for the diagnosis of abnormality allow a high specificity and sensitivity. It is one of the safer medical examinations, and can be completed in three to nine minutes. Costs can also be brought to an appropriate level for mass use, but such screening is hampered by a low yield of true positive tests and an unacceptably high proportion of false positive results. The procedure will become much more cost-effective if restricted to high risk individuals, and has demonstrated value in the management of the "post-coronary" patient.