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Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

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.”

Suspicious Solutions

January 17, 2017

Fifty-two weeks ago yesterday I had hip replacement surgery on my right side. My recovery was so speedy that most people outside the offices of the Michigan High School Athletic Association never noticed, and I was back to my normal activities and workouts very quickly.

But gradually during late summer and then dramatically in early November, my body reacted. It has been giving me pain from hip to foot on my left side, a limp I can’t disguise, and a metaphor for this message.

It appears that correcting one thing adversely affected another thing; and the second problem is much more painful than the first one was.

So-called solutions often have unintended consequences, worse than the original problem. For example:

  • Every expansion of the MHSAA Football Playoffs has had an effect opposite of what was intended. Each has added additional stress on local scheduling and league affiliations; and each expansion has increased the likelihood of repeat champions.

  • Seeding MHSAA Basketball Tournaments, seen by some people as a solution so that the best teams will square off later in the tournament trail, will have those same consequences – stress on scheduling and leagues, and more repeat champions.

  • Relaxing requirements for cooperative programs once seemed like a good thing, but now it is more frequent that schools take the easy route – sending their students off to play on another school’s team – rather than doing the hard thing – providing and promoting the sport themselves. The former provides far fewer participation opportunities than the latter – the opposite of the intended purpose for cooperative programs.

  • Charter schools and School of Choice policies were supposed to force schools to improve through competition, but this “solution” devastated neighborhood schools. These policies didn’t “empower” parents, they created estrangement between schools and communities.

I could go on. The point is, my limp is a reminder to be on the lookout for the new problems inherent in so-called solutions.