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.”
What We’ve Learned
July 12, 2017
Here’s some of what we’ve learned from the first two years of having all Michigan High School Athletic Association member high schools report suspected concussions and make follow-up reports for each.
First and foremost, concussions are of concern beyond football and boys. While football – the highest participation sport – has had the most concussions, the sports that follow are girls basketball (second) and girls soccer (third).
Which leads to the second lesson: Girls report two to three times as many concussions as boys in basketball and soccer, as well as in softball compared to baseball.
Which leads to the third lesson: Whether girls actually experience more concussions than boys or are more forthcoming than boys in reporting suspected concussions, coaches need to coach and communicate with females differently than males; and coach educators must prepare coaches to interact differently with boys and girls.
We’ve also learned that more than 80 percent of concussions caused the athlete to be withheld from activity for six days or longer; and again, there was a tendency to withhold girls longer than boys. In any event, the data suggests that people are taking concussions seriously and not rushing students back into practices or contests.
The data also reveals that more than two-thirds of reported concussions arise from competition, and less than one-third occur during the many longer hours of practice. This is a reversal of the data we were provided a decade ago based on smaller samplings from other states; and this suggests that coaches are finding ways to teach skills and conduct drills without requiring as much player-to-player contact as in the past.
That’s good news. But we’ve also learned from the first two years of data that there is still more to research, more to learn and more to do to make our good games even better.