The early identification of XXXX : can lessons be learnt from cardiac stress testing?

@entity583 @entity146 @entity914 @entity161 @entity716 @entity453
UNASSIGNED: @entity914 including @entity161 are amongst the most debilitating @entity146 . There is an urgent need to develop methods to identify individuals at risk with greater precision and as early as possible. At present, a prerequisite for a diagnosis of @entity161 is the occurrence of a @entity716 . Therefore, attempting to detect @entity161 on the basis of @entity716 is analogous to diagnosing @entity453 ( @entity453 ) after the occurrence of a @entity583 ( @entity583 ). The introduction of cardiac stress testing (CST) has revolutionized the detection of @entity453 and the prevention and management of angina and @entity583 . In this paper, we attempt to apply lessons learnt from CST to the early detection of @entity716 by proposing the development of an analogous @entity716 stress test. We discuss in detail the various parameters of a proposed @entity716 stress test including the choice of a suitable psychological or psychopharmacological "stressor," target population, outcome measures, safety of the approach, and the necessary evolution of test to become clinically informative. The history of evolution of CST may guide the development of a similar approach for the detection and management of @entity914 . The initial development of a test to unmask latent risk for @entity161 will require the selection of a suitable and safe stimulus and the development of outcome measures as a prelude to testing in populations with a range of risk to determine predictive value. The use of CST in @entity453 offers the intriguing possibility that a similar approach may be applied to the detection and management of @entity161 .
