well i dont really like to comment about what other doctors...

well i dont really like to comment about what other doctors do

but given the limited data i would assess his risk factors as most are already aware, next the clear assessment of history is important, more important that the ecg itself and even if the ecg is normal but the history is suggestive and he is in the right age group, i would send him for a stress ecg, stress echo or stress mibi scan to look for exertional ischaemic changes caused by narrowing of arteries by plaque build-up

if that is negative only then i will be happy, cpi may aid in more ppl getting stress test

just with all tests, the economic and clinical viabilty relies upon the false +/- and true +/- which im sure they were published

since cpi is going to be a common pre-test it needs to pick up a lot of potential problems, so it doesnt need to have a high rate of true +ves (100% are given to those end of the road diagnostic tests like angiography which even then is not 100%) but it needs to have very few false -ves i.e potential missouts is low

this may be quite technical for non-medical person but hope it helps

Disclosure - the above is not medical advice, just a commonsense medical approach given a limited clinical situation