Evaluation of technician supervised treadmill exercise testing in a cardiac chest pain clinic

Objective To determine the efficacy and safety of trained cardiac technicians independently performing treadmill exercise stress tests as part of the assessment of patients with suspected angina pectoris. Design Retrospective comparison of 250 exercise tests performed by cardiac technicians and 225 tests performed by experienced cardiology clinical assistants (general practitioners who perform regular NHS cardiology duties), and consultant cardiologists over the same time period. Setting Regional cardiac centre with a dedicated cardiac chest pain clinic. Patients All patients were referred by their general practitioners with a history of recent onset of chest pain, which was suspected to be angina pectoris. Outcome measures Peak workload achieved, symptoms, indications for termination, complications. Results The diagnostic yield of technician supervised tests (percentage positive or negative) was similar to that of medically supervised tests (76% v 69%, NS). The average peak workload achieved by patients was less by 1.2 mets (p