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 - #2
June 1, 2018
Seeding of Michigan High School Athletic Association tournaments, especially basketball and ice hockey, is a topic that routinely finds its way to MHSAA Representative Council agendas.
In May of 2017, the Council rejected a comprehensive proposal to seed the District and Regional levels of MHSAA Basketball Tournaments; but the Council instructed MHSAA staff to examine ideas for limited seeding at the District level only, using an MHSAA-controlled system.
In May of 2017, it appeared there was a small number of Council members who supported the proposal submitted for that meeting by the Basketball Coaches Association of Michigan, and that there were two larger groups – one open to seeding on a more limited basis than BCAM proposed and another group opposed to seeding of any scope by any system.
MHSAA staff responded to the Council’s request by presenting in March of this year and again in May a plan for seeding only the top two teams of each District, to which teams would continue to be assigned by geographic proximity, and then placing top seeds on brackets that would assure those two teams could not meet until the District Finals.
The staff provided answers to the many obvious policy and practical questions, including the system to be used, the games to be included and the placement of teams on brackets.
The effort to arm the Council with these answers had the effect of turning some advocates into opponents of seeding. It was as if the more questions staff anticipated with answers, the more people objected to the plan.
This brought defeat to the plan to seed basketball Districts, and the same to plans to seed ice hockey Regionals and Semifinals.
The questions now are: Do we vote on a fully vetted plan, knowing the details before we move forward; or do we buy a pig in a poke, voting in a concept without details, surprising others and ourselves with how seeding would be implemented? And do we vote on anything at all until we have answered the large philosophical questions as well as the dozens of smaller practical questions that seeding requires we address.