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.”
Cooperative Concerns
July 12, 2016
When an organization receives positive media attention for a policy change, it’s probably best to accept the praise and get back to work. But that could be too easy and miss some teachable moments.
This summer, the Michigan High School Athletic Association has been the recipient of unqualified praise for allowing two or more high schools of any size to jointly sponsor sports teams at the subvarsity level, and for relaxing enrollment limits so that two or more high schools of the same school district could jointly sponsor varsity teams in all sports except basketball and football.
Media seemed to think that this was something revolutionary in Michigan. In fact, the concept of what we call “cooperative programs” in Michigan was borrowed from other Midwest states and began in Michigan during the 1988-89 school year when seven cooperative programs were first approved. Those seven co-ops involved 13 of the MHSAA’s smallest high schools.
Over the next almost three decades, policies have been revised over and over to assist students in schools of larger enrollments, sports of low participation and schools with special circumstances. All of this is admirable; but to be frank, not all results are positive.
The idea of cooperative programs is to increase opportunity. That has often occurred. But increasingly, schools are entering into co-ops not to create new opportunities for participation where they did not exist, but to save opportunities for participation where existing participation is declining – or worse, to combine two viable teams into one to save money.
This trend, and the slight softening of the fundamental principle of educational athletics – that each student competes for his or her own school’s teams – should soften the praise for our most recent expansion of cooperative programs in Michigan.
Entering 2016-17, the MHSAA has nearly 300 high school cooperative programs for nearly 500 sports teams, and nearly 100 junior high/middle school cooperative programs for approximately 340 sports teams. A growing number are not being created with the lofty goals of 1988-89. Instead of the word “create,” we more often see the word “survive” in the cooperative team applications.