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.”
Multi-Sport Imperative
September 15, 2015
Each single-sport organization promoted its own sport, and coaches of those sports tended to pressure athletes to focus on a single sport early in life and eventually exclusively. Parents bought into the fantasy that this early single-mindedness was the key to a college athletic scholarship and even a professional sports career.
While we spoke of a high-minded philosophy, on the local level, as a practical matter, more and more coaches and athletes were pursuing an ever-narrower sports experience. Until now.
Starting very recently, the conversation has changed, or at least it’s been joined by new voices. We’ve learned that Big Ten football coaches favor recruits who play more than football in high school. We’ve learned that our fantastic Women’s World Cup Soccer champions were almost all multiple-sport athletes in secondary school. We’ve learned that the hottest young U.S. golfer on the Men’s PGA Tour was a multiple-sport enthusiast in his teens. We’ve seen a half-dozen high profile sports executives with school-aged children advocate for a more balanced experience for their kids. And now we see several dozen amateur and professional sports organizations have joined a campaign to oppose the negative trends in youth sports and to promote a more balanced, healthier sports experience for children and adolescents.
And there it is – a healthier experience. Suddenly, our philosophy that multiple-sport participation is better for youth than sport specialization has been made a health and safety issue, which we’ve known all along but have not emphasized enough.
Now, with attention to over-use injuries and burnout, sport specialization has become a health and safety crisis on the level of concussions, heat illness and sudden cardiac arrest. Multi-sport participation has become a health and safety imperative. A matter of good public policy.
We need to catch and ride this wave for all it’s worth. In the same way the environmental movement catches fire when presented as a human rights issue – that people everywhere have a basic right to clean air and water – we must present sport specialization as a threat to young persons’ health and safety – a risk as great as head trauma, heat illness and heart failure, requiring the kind of bold policies and programs we’ve implemented in recent years to address those equally serious problems.