Patients with mixed defects, multiple defects, equivocal studies, and stress-only studies were excluded since well-defined defects were desirable in this first patient study.
The number of equivocal studies decreased when evaluating the repeated studies compared to the first studies for all physicians, both for the interpretations of ischemia and for infarction.
For the second physician, the number of equivocal studies decreased from 50 to 21 for ischemia (P < 0.0001) and from 24 to 11 for infarction (P = 0.007).
One of the investigators (ET) categorized all patients into the following groups: normal studies, anterior infarction, apical infarction, lateral infarction, inferior infarction, anterior ischemia, apical ischemia, lateral ischemia, inferior ischemia, mixed defects, multiple defects, equivocal studies, and stress-only studies.
The number of equivocal studies, interpreted by physicians, decreased when evaluating the repeated studies compared to the first studies for all physicians, both for the interpretations of ischemia and for infarction.
For the first physician, the number of equivocal studies decreased from 16 at the first acquisition to 8 at the reacquisition for ischemia (P = 0.10) and from 9 to 8 for infarction (P = 0.99).
For equivocal studies, the OR was 1.2 (95% CI 0.7 1.9, reference: positive studies, OR 1.0).
Equivocal studies containing phrases such as "possible steatosis" or "inflammation or steatosis" were excluded from the final analysis.
These data illustrate that failure to recognize, specify, and consider these factors is likely to result in equivocal studies subject to possible misinterpretation.
The combined results are equivocal: several studies report no observable differences as a result of fasting and others show specific deficits on tasks designed to test psychomotor speed, executive function, and mental rotation.
Regarding the positive predictive value (PPV) the findings are equivocal: some studies report that the values of PPV were similar for each method separately and for their combination, while others report smaller values of PPV for their combination.
