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Diagnostic accuracy of technician supervised and reported exercise tolerance tests
  1. D F Muir1,
  2. M Jummun2,
  3. D J Stewart2,
  4. A L Clark3
  1. 1Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK
  2. 2Department of Cardiology, Western Infirmary, Glasgow, UK
  3. 3Department of Cardiology, Castle Hill Hospital, Hull, UK
  1. Correspondence to:
    DF Muir;

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Ischaemic heart disease (IHD) is a common condition with an annual hospital admission rate in England and Wales of around 6.3 per 1000.1

Guidelines produced by the joint audit committee of the British Cardiac Society and Royal College of Physicians recommend exercise electrocardiography in most new cases of angina. In accordance with current guidelines,2 many of these tests are now supervised by senior cardiac technicians without direct medical supervision.

In our centre, around 2000 exercise tests are performed annually, 80–90% of which are technician supervised. All tests are reported by medical staff, which necessitates a significant increase in resources and an increase in reporting time. The purpose of this study was to evaluate the ability of experienced technical staff to provide accurate reports for technician supervised exercise tests.


A total of 246 consecutive technician supervised exercise tests were collected prospectively. Tests were excluded if the requesting physician had indicated that medical supervision was required (n = 23), if bundle branch block was present at rest (n = 15), or where the purpose of the test was not primarily for the assessment of IHD (n = 8), leaving 200 tests for assessment.

All tests were performed to Bruce or modified Bruce protocols. Each …

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