A computer program to predict when cardiac catheterization is a cost effective test after treadmill testing

There has been an increased desire to utilize predictive models to guide medical therapy and testing. To improve the value of exercise testing, and to compare two prognostic tools, a computer program was developed to predict the probability that cardiac catheterization followed by coronary artery bypass surgery is a cost-effective strategy after treadmill testing. The 1-year chance of mortality is calculated from the exercise parameters. Expected improvement in survival with cardiac bypass is calculated utilizing the LIFESPANS life expectancy function. This is then adjusted for perioperative mortality based on noninvasively obtainable parameters. In low risk patients, cath is usually not recommended, while in high risk (>5% annual mortality), cath is usually recommended. Intermediate risk patients frequently benefit from cath. This program should help guide clinical practice in patients undergoing stress testing