When it comes to deciding whether to screen asymptomatic adults for coronary artery disease (CAD) with either a resting or exercise ECG, the U.S. Preventive Services Task Force (USPSTF) has not changed its guidelines since its recommendation in 2004 against such routine screening. This year, a group of researchers from the Oregon Health and Science University looked into whether the guidelines were due for an update.
In a new study published in the Annals of Internal Medicine, Dr. Roger Chou and colleagues reviewed evidence that had been accumulated since the previous analysis to determine if the USPSTF guidelines should be revamped. After analyzing data from over 160,000 patients, the researchers did find that resting ECG abnormalities were associated with an increased risk of future cardiovascular events, yet no studies evaluated how the screenings would allow doctors to make better treatment decisions, and thus affect outcomes.
As Dr. Michael S. Lauer from the National Heart, Lung, and Blood Institute writes in an accompanying editorial, We cannot assume that because a clinical measurement predicts risk, incorporating it into clinical care will reduce risk.
ACSH's Dr. Gilbert Ross notes with some nostalgia: When I was in practice in the 1980s and 90s, routine ECGs were not only advised, they were expected or demanded by most patients at least those over 40. We didn t have the benefit of such analyses to guide our decision-making; it just seemed logical to do it the way it had always been done. Not anymore.
