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.”
Oyster Stew
November 13, 2015
Jonathan Swift, an 18th Century writer I was introduced to as an English major in college, grabbed my attention and loyalty with the statement, “He was a bold man who first ate an oyster.”
I’ve hated oysters for their look, their texture and their taste; and also because, as a child, oyster stew was the Christmas Eve fare that stood between me and the time when we could begin opening presents under the Christmas tree.
But I have loved Swift’s metaphor.
Imagine the courage – or the desperation – of the first person to eat an oyster … or any other ugly, slimy critter ... raw!
But it is often this person, bold or desperate enough, who looks past appearances to tackle something of such unpleasant prospects, who actually makes the discovery or connects the dots or makes the breakthrough necessary for real progress.
What are the most unappetizing issues before us? Transfers? Football scheduling? Specialization? What unappealing solutions might we be avoiding because they look so awful? Are we bold enough to take a bite out of them?