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.”
Counting Concussions
December 9, 2016
Member high schools of the Michigan High School Athletic Association are in the second year of required reporting of concussions that occur during practices and contests in all levels of all sports served by the MHSAA. In year one there were 4,452 confirmed concussions reported. Less than two percent of almost 300,000 participants sustained a concussion, about half of which caused the student to be withheld from activity for between five and 15 days.
Not surprisingly, approximately half of the confirmed concussions were reported by Class A schools, which typically sponsor more sports and have larger squads than smaller schools. Class B schools provided almost 30 percent of the reports; Class C schools nearly 15 percent; and Class D schools less than six percent.
As we transition from fall to winter season, we can begin to make comparisons between years one and two of the mandated reporting. At this point, schools are reporting 1.6 percent fewer concussions this year than last.
This is surprising, because sideline personnel of member high schools have become more alert to the signs and symptoms of concussions. We anticipated that this would lead to more concussions being reported.
It is possible that these early stats are a sign of real progress in reducing head injuries in school sports. And, grabbing our attention most from the early reports is that 11-player football is reporting 3.9 percent fewer concussions as of Nov. 30, 2016 compared to the same week in 2015; and boys soccer is reporting 10.9 percent fewer than on the same date last year.