Welch Allyn CardioPerfect Workstation Exercise ECG Module - User Manual - Manual (Page 79)

CardioPerfect Workstation
Exercise ECG Module - User Manual
DIR 80012335 Ver. E 79 / 83
15. Additional information
15.1 Duke Treadmill score
The Duke Treadmill Score (DTS) was introduced by DB Mark cs
1
. According to the ACC/AHA
Practice Guidelines, the Duke Treadmill Score adds significant prognostic information to the
standard clinical data
3
. Besides improving diagnostic and prognostic accuracy, scores
eliminate physician bias and lessen the variability of decision making
2
.
The Duke Treadmill Score is calculated as follows:
DTS = Exercise time
min
– (5 * ST-segment deviation
mm
) – (4 * Exercise angina index)
Angina index has a value of:
0 for no exercise angina
1 for non-limiting angina
2 for exercise-limiting angina
The Exercise time is originally measured in minutes of the Bruce protocol, which can be
derived from attained metabolic equivalent. The resulting more universal version of this score
translates the exercise duration (which assumes the Bruce protocol) from maximum attained
METs, making it applicable for any exercise protocol or device type for which METs can be
calculated or measured.
Risk stratification based on the Duke score is estimated as:
Score: Risk:
> 5 Low risk
-10 < Score < 5 Medium risk
< -10 High risk
The Duke Treadmill Score (DTS) is shown in the Summary tab if selected in the Summary
template under Test results. See page 55 for more information.
Note: The Duke Score is not applicable for pharmacological stress testing; it is only
applicable if the selected exercise device is physically used.
The Duke Score is not calculated if the Test type is not “Exercise.”
Input variables:
“Symptoms during test” - used in determining Angina Index.
“Reason for terminating test” - used in determining Angina Index.
“Stess Test type” - if not a standard Exercise test, i.e.
Pharmacological or other, then no DTS
calculation.