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.”

It’s Change, Not Status

January 5, 2016

When I see a professional sports team install a scoreboard that is more expensive than the total of the interscholastic athletic budgets of the two dozen high schools closest to that stadium, I gripe.

When I see a half-dozen medical professionals scamper out to attend to an injured college football player, and then watch a local high school junior varsity soccer game where no medical professional is present, I grieve.

But in spite of these dispiriting moments, I never wish that my life’s work had been at those higher levels. Long ago I was impressed by the statement that we should measure impact by change, not by status.

It is at the school sports level, much more than at so-called higher levels, that lives are changed. No glitz. No glamour. Just huge results, with limited resources.