Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”
Show of Hands
July 12, 2017
Four dozen years ago, my boss, the executive director of the National Federation of State High School Associations, expressed to me his disappointment that one of the characteristics of NFHS national meetings was the much too frequent “show of hands.” That is, someone from one state would rise to ask for a show of hands on a topic: “How many states do this? ... How many states don’t? ... How many do that?”
My mentor’s point was that the time would be much better spent on a qualitative analysis of the topic, rather than a quantitative one ... a discussion of the merits of a particular policy or procedure, rather than a head count.
His message to me is recalled every time a proposal comes to the Michigan High School Athletic Association to change this or that policy and is accompanied by the meager rationale that it’s what 25 or 35 or 45 other states might do. That stat holds only mild interest for me.
Before we do anything here to be like anybody elsewhere, we need to measure the pros and cons in our place and time ... how it fits our culture or our climate, for example.
When we consider change in the start or end of seasons; or the number of interscholastic scrimmages or contests in a day, week or season; or the number of exceptions to the transfer rule or the length of ineligibility when no exception applies; or the number of classes or divisions for tournaments; or the existence or extent of seeding for a tournament; when we consider any of these things in Michigan, we need much better rationale than a show of hands.