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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.”
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Girls, Boys and Concussions
September 13, 2016
On Monday the Michigan High School Athletic Association announced the major findings from the first year that member high schools were required to report all suspected concussions in the practices and competitions conducted in the 28 sports served by the MHSAA.
It surprises no one that 11-player and 8-player football ranked first and third, with 49 and 34 head injuries per thousand participants, respectively.
And while I’m told it’s not surprising to the experts that girls report more head injuries than boys, it is stunning to me how very many more head injuries are reported for girls than boys.
In sports with identical playing rules, girls reported head injuries with approximately twice the frequency that boys did.
In soccer, girls reported 30 head injuries per 1,000 participants, compared to 18 per 1,000 for boys.
In basketball, girls reported 29 head injuries per 1,000 participants, compared to only 11 per 1,000 for boys.
Girls reported concussions at the rate of 11 per 1,000 participants in softball, while boys reported just 4 per 1,000 in baseball.
Only a small percentage of either girls or boys were cleared by licensed medical personnel to return to activity in less than six days, and more than half were withheld between six and 15 days in soccer and basketball. The data suggests that clearance for girls to be returned to activity was slightly more gradual than it was for boys.
Researchers and reporters may find dozens of other observations and curiosities from the summary of 4,452 confirmed head injury reports submitted by the MHSAA’s 755 member high schools for MHSAA-supported sports in 2015-16; but what has the MHSAA’s attention is this giant gender difference.
Is this gender difference accurate, and if so, what are the physiological factors involved that make it so?
Is there a tendency for over-reporting by females, or under-reporting by males, and if so, what are the social and/or psychological factors that may cause this?
Regardless, what does this mean for how coaches work with boys and girls; and what does that mean for how we prepare coaches through the MHSAA Coaches Advancement Program?
The MHSAA will take to an even deeper level its nearly 30-year partnership with the Institute for the Study of Youth Sports at Michigan State University to explore the issues related to coaches education that have emerged as a result of the first year of mandated concussion reporting for Michigan high schools.
The 2015-16 school year was only a start; it identified some initial themes. The more important value will be realized after the 2016-17 school year, and subsequent school years, when year-over-year comparisons will be made and trends will become apparent that will demand action to further promote the welfare of participants in school-sponsored sports.