From the Research
Ordering a Nuclear Stress Test
- A Primary Care Physician (PCP) can order a nuclear stress test, but the decision to do so should be based on appropriate use criteria and patient selection 1, 2.
- The 2009 Appropriate Use Criteria for radionuclide imaging provides guidelines for ordering nuclear stress tests, but inter-rater reliability among physicians is modest, and there is variation in the ability to identify inappropriate tests 3.
- Primary care providers can gain confidence in test selection, the testing process, and interpreting results by understanding the current methods of cardiac stress testing 4.
- Exercise-based stress tests are generally preferred, but nuclear imaging stress tests may be more suitable for certain patients, such as women 2.
- The choice of stress test modality depends on patient characteristics, clinical status, and medications, and PCPs should consider these factors when ordering a stress test 2, 5.