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.”

Data is Due

December 4, 2015

Allow me to wander way outside my expertise for a moment … to quantum physics. I believe this is the discipline where it is said that “something doesn’t exist until it is described and measured.”

This statement embodies one of the reasons the MHSAA has mandated that, beginning this school year, member schools must report all possible head injuries in the practices and events of school sports. We want to get at least a general description and approximate measurement of our story here as we listen to the nationwide narrative about health and safety in school sports.

Early returns – that is, preliminary numbers for fall sports – are being presented to the MHSAA Representative Council today. A public release will follow before the end of the year. A more complete report – based on fall, winter and spring sports – will be provided after the conclusion of the 2015-16 school year. And in the future, year-to-year comparisons of the numbers will provide a more meaningful story.

The MHSAA is also gathering data from two pilot programs that are intended to increase attention on sideline concussion detection and recordkeeping, and also from the concussion care insurance the MHSAA has purchased for all participants in all MHSAA member junior high/middle schools and high schools beginning this school year.

Data from all three initiatives may help those who make the equipment and prepare the rules of play in the ongoing campaign to make our good school sports programs even better.