We forced the variables from the basic clinical model and the resting ECG model into the models with data on the exercise ECGs.
We then used the covariates that remained statistically significant at the 5% level in each model to build three incremental models: basic clinical assessment, basic clinical assessment plus resting ECG, and basic clinical assessment plus resting ECG plus either summary exercise ECG or detailed exercise ECG.
In addition, including either the cTnT concentration or a GLS ≥ −15% in the model incorporating the basic clinical parameters also increased the predictive power of the model.
Predictive models included a basic model (age, sex, symptoms, and setting), clinical model (basic model factors and diabetes, hypertension, dyslipidaemia, and smoking), and extended model (clinical model factors and use of the CT based coronary calcium score).
Moreover, a multivariate model including basic clinical parameters, troponin I and BNP, is presented in Table 8.
Only basic clinical characteristics were used in these models and data were limited to information available for all participants.
"The Buch-Model, with its closely interacting basic, clinical, and applied research is unique in Germany," says Ernst-Ludwig Winnacker, president of the Deutsche Forschungsgemeinschaft DFGG).
The clinical model improved the prediction, compared with the basic model (cross validated c statistic improved from 0.77 to 0.79; table 2).
The clinical model improved the prediction, compared with the basic model (cross validated c statistic improvement from 0.77 to 0.79, net reclassification improvement 35%); the coronary calcium score in the extended model was a major predictor (0.79 to 0.88, 102%).
