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.”
The Seeding Disease
May 1, 2018
I have yet to hear one satisfactory reason to advocate for seeding an all-comers, 740-team high school basketball tournament. But this I do know: Advocates of seeding are never satisfied.
Seeding high school basketball tournaments has become the rage since the NCAA Division I Men’s Basketball Tournament, still just a 68-team affair, became a billion dollar media business. Many people assume that what is used for this limited invitational college tournament is needed and appropriate for a high school tournament that involves 11 times as many teams.
The NCAA pours millions of dollars into the process of selecting and seeding its 68-team tournament, combining a variety of data-based measurements with the judgments and biases of human beings.
One of this year’s questionable selections to make the 68-team field was Syracuse ... which sent our more highly touted and seeded Michigan State Spartans back home early in the tournament.
Meanwhile, low-seeded Loyola-Chicago upset four teams on its way to the Final Four, and became the favorite of fans nationwide. Which argues for upsets. Which argues for randomness.
Which argues against seeding. Why pick the No. 1 seeds of four regions and have all four glide to the Final Four? What fun would that be?
A local sports columnist who is an outspoken advocate for seeding our state’s high school basketball tournament actually wrote a published column advocating for “more Loyolas” in the NCAA tournament, and he explained how to make that happen. Which, of course, seeding is designed to not make happen, but instead, to grease the skids for top-seeded teams.
When the NCAA Final Four brackets for San Antonio resulted in two No. 1 seeds on one side, playing in one semifinal game (Kansas and Villanova), while the other side of the bracket had a semifinal with a No. 3 seed (Michigan) and a No. 11 seed (Loyola), there was a call for more finagling ... for reseeding the semifinals so that the two No. 1 seeds wouldn’t have to play until the final game.
It was poetic justice to watch one No. 1 seed clobber the other No. 1 seed in a terrible semifinal mismatch.
The point is this: Seeding is flawed, and advocates of seeding are never satisfied. If we take a small step, they will want more steps. If we seed the top two teams of Districts, they will lobby for seeding all teams of the Districts. If we seed all teams of Districts, they will ask for seeding Regionals. And, if we seed the start of the tournament, they will want a do-over if it doesn’t work out right for the Finals.
Seeding is a distraction, and an addiction.