Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

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 Massachusetts Model

August 19, 2016

Late last spring the veteran executive director of the Massachusetts Interscholastic Athletic Association, Bill Gaine, spent a half-day at the offices of the Michigan High School Athletic Association to share insights about ways state association staff can serve the mission of educational athletics. Here are some of my notes from that experience:

  • “Steal and build.” At the MIAA, the approach has been to steal the good ideas of others and build upon those ideas.

  • “Marry student life with academic life.” The MIAA leadership tries to make an intentional, purposeful connection between the after-school and school programs of MIAA schools.

  • “Connect rhetoric with policies and programs. You can’t have just policies or only programs; you must have both.”

Over 18 years, five pillars of policy and programs have evolved for the MIAA: Health and Wellness in 1984, Sportsmanship in 1993, Coaches Education in 1998, Student Leadership in 2001, and Community Service in 2002. All constituents get the whole package all the time, according to Gaine; and there is an MIAA staff person in charge of each pillar.

The “5 Pillars” is the curriculum the MIAA teaches athletic directors, with specific lesson plans. Gaine says, “The AD is the school’s curriculum coordinator for educational athletics.”