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.”

Pilot Programs 2.0

May 10, 2016

Two sideline concussion detection pilot programs launched with 62 schools at the start of the 2015-16 school year will continue in 2016-17, with several significant modifications.

For the upcoming school year, a smaller number of schools will be invited to participate, training will be both earlier and longer, and the focus will be on those sports which the MHSAA’s mandated concussion reporting by all high schools has identified as having the highest risk for head injuries.

The primary purpose for the MHSAA to initiate, drive and monitor these pilot programs is to emphasize the removal-from-play phase of the concussion care continuum, and to encourage more care, consistency and courage during that decision-making process.

Data from the most recent fall and winter seasons tends to demonstrate that schools in the pilot programs reported more concussions than non-pilot schools and they withheld students from activity longer than schools which did not participate in the pilot programs.

These tendencies are supported by both systems being tested, King-Devick and XLNTbrain, both of which have significant improvements in store for pilot schools in 2016-17.

The purpose of the pilot programs is not to select a single system to be recommended to or required of all MHSAA member schools, but to demonstrate to vendors how to serve the needs of our diverse constituency and to help our schools serve their student-athletes better. Further progress toward these purposes is a certainty during 2016-17.