
The Predictive Capabilities of Clinical Tests: The 6-Minute Walk-Reply
Vera Bittner, MD;
William J. Rogers, MD
University of Alabama at Birmingham
Debra H. Weiner, MPH
University of North Carolina at Chapel Hill
Marvin W. Kronenberg, MD
Vanderbilt University School of Medicine Nashville, Tenn
Barry Greenberg, MD
Oregon Health Sciences University Portland
Kevin M. McIntyre, MD
Brigham and Women's Hospital Boston, Mass for the SOLVD Investigators
JAMA. 1994;271(9):662.
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In Reply.
—Dr Mark suggests three criteria by which clinicians should judge a new clinical maneuver. The first is the amount of prediction: We agree that both absolute risks and RRs should be considered and have provided information on both in our article. Relative risks are most useful when comparing one predictive variable with another in the same patient population. In our study, for example, the point estimates of the two statistically significant odds ratios (ORs) for death were 1.74 for a 15% decrement in ejection fraction and 1.5 for a 120-m decrement in walking distance. These results indicate to the clinician that walking distance was the second-best predictor of prognosis among the variables evaluated in our model and was nearly as good a predictor as ejection fraction. Absolute risk is more relevant when the test is applied to a single patient. In our population, the risk of dying increased
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