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.”
Sweating the Small Stuff - #3
June 5, 2018
I’m sure it discouraged some of our state’s high school football coaches to learn that the Representative Council of the Michigan High School Athletic Association did not approve at its May 6-7 meeting what some people refer to as the “enhanced strength of schedule proposal” for determining 256 qualifiers to the MHSAA’s 11-player football playoffs.
There was desire among some Council members to appease those who keep trying to reduce the difficulties that a football tournament causes for regular season scheduling and conference affiliations. Others noted that the proposal, as presented, could cause as much harm to some schools and conferences as it would help others, that it did not solve the scheduling problem but shifted it.
During spirited discussion, some Council members resurrected two ideas that have been rejected previously, such as (1) doubling the playoffs once again (and shortening the regular season to eight games), and (2) coupling a six- or seven-win minimum with the revised strength of schedule criteria. The pros and cons of each idea flowed freely.
And therein is the problem. If one digs down into the details of proposals, both old and new, there are both positive and negative aspects apparent, both intended and unintended consequences likely.
There can be paralysis in analysis; but when we are dealing with more than 600 high school programs and a physically demanding sport with fewer regular-season contests permitted than in any other sport, one cannot be too careful. Eliminating one of just nine regular-season games? Increasing first-round tournament mismatches? Disadvantaging larger schools locked in leagues or areas of the state where smaller schools predominate? These are not minor matters.
And until there are sensible answers, these are not trivial questions.