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 Most Important Decisions

October 13, 2015

During the course of contests, coaches and officials make many mistakes – not as many as spectators might think, of course – but mistakes certainly do happen. In the heat of competition, most are quickly forgotten.

Those mistakes that occur near the end of games or are caught on camera can live longer than dozens of more consequential decisions earlier in the event that might later be determined to be incorrect in the 20/20 hindsight of “Monday morning quarterbacking.” But it is extraordinarily rare that any decision during a contest defines a career, or ends it.

No, the decisions that do most to damage, detour or destroy a coaching or officiating career are those made away from the contest. A bad impulse during a social outing, indiscreet comments or conduct caught on video and sent worldwide overnight, or an inappropriate email or website search ... these are the decisions that end up defining the career.

The stakes may be higher for decisions made away from the sport by coaches and officials than the decisions they make in the athletic arena. Every week’s sports news tells me this is correct. Hundreds or even thousands of people may witness a judgment call during a contest, while millions upon millions will be exposed to poor judgment exercised away from the contest.