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.”
Correctable Error?
May 30, 2017
A decade has passed since the court-ordered change in several sports seasons for Michigan high schools. Ten years has brought resignation more than satisfaction; and yet there remains hope in some places that the new status quo is not permanent, at least for those sports seasons changes that were and are seen by many people as collateral damage in a fight over seasons for girls basketball and volleyball.
Actually, the lawsuit sought to place all girls seasons in the same seasons as boys, like college schedules. The federal court did not require simultaneous scheduling; but the court did bring the intercollegiate mindset to the case. It determined, regardless of other facts, that the intercollegiate season was the “advantageous” season for high school sports. And the principle upon which it approved the compliance plan for high school sports in Michigan was that if all the seasons were not simultaneous for boys and girls, then there should be rough equality in the number of boys and girls assigned to “disadvantageous” seasons.
So, for example, from the federal court’s perspective, fall is the advantageous season for soccer, winter for swimming & diving, and spring for tennis. As for golf, the court opined that, even though it’s not the season of the NCAA championships, maybe fall was the better season. The court began with tortured logic and ended with hypocrisy.
As a result, in the Lower Peninsula, regardless of the preferences of the people involved, girls and boys had to switch seasons in two sports to even up the number of boys seasons and girls seasons in what the court had determined were disadvantageous. Schools thought the switch of golf and tennis for the genders was less injurious than switching soccer and swimming.
In the Upper Peninsula, because swimming and golf are combined for the genders in the winter and spring, respectively, the court’s option was to switch boys and girls seasons for either soccer or tennis. The schools chose soccer as the least disruptive change.
As people count the damaging effects and think about challenging the court-ordered placements a decade later, they must understand the court was looking for balance, for having the genders share the burden of participating in disadvantageous seasons. Moving Lower Peninsula boys golf to join girls in the fall and/or switching Lower Peninsula boys and girls tennis back to what was preferred and in place before judicial interference would recreate the imbalance the federal court conjured up and sought to remedy.
Those of us involved see many advantages to conducting fall golf for both genders in the Lower Peninsula and switching Lower Peninsula tennis seasons for boys and girls, no matter when colleges schedule those sports or how impractical the court’s logic and how inconsistently it was applied. Nevertheless, correcting the court’s errors could be both contentious and costly.