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 Rules We Use

February 9, 2016

The MHSAA Handbook of 90 years ago consisted of merely 21 pages, a diminutive 3½ x 6 inches in size.

The proposals for just the changes in the Handbook for 2016-17 require almost as many words as the entire Handbook of 1925-26.

The Handbook has grown to 130 full-sized, 8½ x 11-inch pages not just because we serve more sports and students than 90 years ago. It also grows because life is much more complicated. Society, schools and sports have much broader concerns today.

Every policy described in the current Handbook got there as a response to people wanting more rules or recommendations – sometimes to treat students better and other times to promote competitive equity, both of which are worthy objectives and should continue to be the rationale for proposals.

Occasionally I hear my colleagues in other states say we need to modernize our rules, to be sure we are not trying to apply 20th century rules to 21st century problems. I don’t disagree with that populist refrain.

However, before any rule is removed, those in charge must ask and answer: “How will school sports look without this rule? Will the problem this rule was created to solve return if we remove the rule? Will doing so create even worse problems?”

Rarely has the adoption of a new rule by our organization been a mistake. I cannot say the same for the removal of rules.