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.”
Leadership Impressions - #3 (Embracing Interruptions)
June 15, 2018
I was once told that “the job is the interruptions” – to look at an interruption not as something that detracts from my work but rather is the work. But there are two types of interruptions that have gotten my special attention over the years.
One type happens often, perhaps twice a week when averaged over the course of a year. It happens when the assistant directors of the Michigan High School Athletic Association are asked a novel Handbook question, one of first impression in their experience, and there is a difference of opinion among their colleagues as to the correct answer.
I expect to be involved in answering such questions; and sometimes I determine that the question needs MHSAA Executive Committee attention – for ultimately under the MHSAA Constitution, it is the Executive Committee’s responsibility to interpret what is not clear in Handbook Regulations and Interpretations.
The other type of interruption happens not twice a week but about twice a year, when a legal challenge confronts the MHSAA. It has been our practice to keep other staff focused on the daily business of the MHSAA, helping to make tournaments and other programs operate without distraction; while the executive director (as well as the associate director in more recent years) deals with litigation, which is usually a three- to six-month sprint but can also be a three- to six-year marathon.
I expect to insulate other staff from these diversions that can suck time and energy out of a forward-looking staff.
We anticipate that every day will bring us questions that were not on that day’s to-do list. We try to treat those interruptions as an important part of our work.