💓 Duke Treadmill Score
Risk-stratify exercise ECG results with the Duke Treadmill Score.
Clinical takeaway
Validated for the Bruce protocol.
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When to use
Estimate prognosis after a Bruce-protocol stress test.
How it works
Score = exercise time (min) − 5 × ST deviation (mm) − 4 × angina index (0/1/2). ≥ +5 low, −10 to +4 moderate, < −10 high risk.
Key points
- Validated for the Bruce protocol.
- Low-risk results carry an excellent prognosis.
- High-risk results may prompt angiography.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Exercise time (Bruce) | 9 min |
|---|---|
| Max ST deviation | 1 mm |
| Exercise angina | None |
→Duke TMS4
- Risk group：Moderate risk (~1.25%/yr)
- Formula：time − 5 × ST(mm) − 4 × angina index
| Exercise time (Bruce) | 9 min |
|---|---|
| Max ST deviation | 1 mm |
| Exercise angina | Limiting (test stopped) |
→Duke TMS-4
- Risk group：Moderate risk (~1.25%/yr)
- Formula：time − 5 × ST(mm) − 4 × angina index
Frequently asked questions
- What is Duke Treadmill Score?
- Risk-stratify exercise ECG results with the Duke Treadmill Score.
- How is Duke Treadmill Score calculated? What is the core formula?
- Score = exercise time (min) − 5 × ST deviation (mm) − 4 × angina index (0/1/2). ≥ +5 low, −10 to +4 moderate, < −10 high risk.
- When is Duke Treadmill Score used?
- Estimate prognosis after a Bruce-protocol stress test.
- What are the key clinical points for Duke Treadmill Score?
- Validated for the Bruce protocol. Low-risk results carry an excellent prognosis. High-risk results may prompt angiography.
- What are the limits and cautions when using Duke Treadmill Score?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Duke Treadmill Score calculated in practice? Can you show a worked example?
- Inputs: Exercise time (Bruce) 9 min, Max ST deviation 1 mm, Exercise angina None → Result: Duke TMS 4（Risk group: Moderate risk (~1.25%/yr), Formula: time − 5 × ST(mm) − 4 × angina index） Inputs: Exercise time (Bruce) 9 min, Max ST deviation 1 mm, Exercise angina Limiting (test stopped) → Result: Duke TMS -4（Risk group: Moderate risk (~1.25%/yr), Formula: time − 5 × ST(mm) − 4 × angina index）