Agreement on the accuracy of thallium stress testing.

I. The average reported sensitivity and specificity of thallium exercise testing in 2,877 cumulative cases published since 1983 (2-7), weighted for the number of cases in each study, is 83% and 53%, respectively, associated with approximately 17% false negative and 47% false positive results (Table I). 2. Referral bias cannot completely explain this poor diagnostic accuracy, which is therefore a real limitation, reducing clinical utility of thallium stress testing as currently used. 3. This degree of error in a noninvasive diagnostic test incurs considerable economic and personal costs related to making the correct diagnosis by coronary arteriography, as reported in studies (14-16) published since that editorial comment (1).