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.”
The Usual Suspects
December 30, 2016
It is difficult to find a year when the 11-player Football Finals of the Michigan High School Athletic Association involved more teams from southeast Michigan than appeared at Ford Field in 2016. In fact, just two counties (Oakland and Wayne) produced seven finalists. But then two counties on Michigan’s west side (Kent and Muskegon) supplied four of the 16 finalists.
Four of Michigan’s 83 counties producing 11 of 16 finalists in the 11-player championship games doesn’t’ feel like a statewide event; but one team from the Upper Peninsula, another from the Leelanau Peninsula in the northwest portion of the Lower Peninsula, and a team located along the Michigan/Ohio border remind us how large and diverse our state really is.
The 2016 MHSAA 11-player Football Finals consisted of many of the “usual suspects,” including two teams pursuing their fourth straight titles and one team seeking its third consecutive championship. Four of the eight 11-player champions from 2015 returned in the attempt to defend their titles in 2016, and two of the runners-up in 2015 were back to try to reverse their fortunes from 12 months earlier.
What is being demonstrated here in Michigan high school football is the trend seen in many other states. That is, as the number of classes or divisions of tournaments expands, the more often you see the same teams in the final rounds.
The surest way to have the “usual suspects” on championship day is to put them in tournaments with fewer schools. And of all MHSAA tournaments, the football playoffs have the most divisions with the fewest schools in each. The result is predictable.
This is a cautionary tale for those who desire that the number of classifications and divisions be expanded in MHSAA tournaments for other sports.
Meanwhile, we are keeping an eye on the tournament format in a neighboring state that places schools into divisions for larger schools after they are too successful over consecutive years in the classification that fits their enrollment. Those in Michigan who have been assigned to review such policies have complained that such “success factors” penalize future students because of the achievements of previous students and/or because such factors do nothing about “chronic success” by schools in the largest classification.