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.”
Beyond Fairness
April 11, 2017
One of the lessons I learned decades ago when I was employed at the National Federation of State High School Associations (NFHS) is that sometimes the playing rules are not fair.
The NFHS is the publisher of playing rules for most high school sports, and its rule books govern competition for most of the contests for most of the high schools in the U.S.
But the NFHS doesn’t publish the most fair rules. On purpose.
The rules for the high school level attempt to do much more than promote competitive equity, or a balance between offense and defense; they also attempt – without compromising participant health and safety – to simplify the administration of the game.
Unlike Major League Baseball, where umpires officiate full-time, and professional basketball, football and ice hockey where they officiate nearly full-time, the officials at the high school level are part-timers. They have other jobs. This is their avocation, not their vocation.
So the NFHS develops and publishes rules that minimize exceptions to the rules. In football, for example, there are fewer variables for determining the spot where penalties are enforced.
At the high school level, the rule makers intend that the rules be – for players, coaches and officials alike – quicker to learn, simpler to remember, and easier to apply during the heat of contests.