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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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The Limitation of Rules – Part 2
September 6, 2016
There may be an inverse relation between the length of the Michigan High School Athletic Association Handbook and the commitment to follow its rules.
There seems an increasingly popular attitude that if something isn’t specifically prohibited, then it’s permitted. The question is more often “Is it legal?” and less often “Is it right?” Technical integrity rather than ethical integrity.
There may not be more rule breakers today, but there sure seems to be more rule benders – people at the borders of what is allowed, testing limits.
Which leads to an even longer Handbook as efforts are made to plug the holes and fill the gaps.
Which is a temptation we must resist, for we cannot keep up. Like a dog chasing its tail, we’ll go in circles. Getting dizzy. Losing sense of what is important.
We were successful in that the 2016-17 MHSAA Handbook has the same number of Interpretations as the year before. A whopping 284 Interpretations. Our goal for 2017-18 should be fewer.