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.”
The Waiver Process
August 21, 2015
Last school year, over the course of 12 meetings, the MHSAA Executive Committee received 467 requests from member schools to waive either a minimum standard for student eligibility or a maximum limitation on competition. Three hundred sixty-two of these requests for waiver were approved. That’s 78 percent.
This was a typical year – neither a record high nor record low in the number of requests, or of waivers approved.
Under the MHSAA Constitution, to at least some degree, every Handbook regulation may be waived by the Executive Committee. However, it is an abuse of authority if there is not a compelling reason for the waiver – that is, a clear case where the rule works an undue hardship (not just any hardship) on a student or school, or the rule fails to perform its intended purpose in the particular and unique circumstances documented.
There are times when school administrators will disagree with an Executive Committee determination, and more times when parents will disagree – and sometimes the difference of opinion leads to unjustified attacks on the MHSAA or individuals. This is unfortunate, but inevitable when critics see their situation alone and not in the context of past and future precedent.
Nevertheless, in recent years, fewer than one in 400 waiver requests that is not approved has been appealed to the full MHSAA Representative Council. I believe this reflects not only that the Executive Committee has been getting the decisions right, but also that those who are making the requests have felt well heard and served.
We work hard to create that atmosphere, even in the presence of emotional, invested parents who are advocating for their children. From a real live receptionist who greets every telephone caller, to our associate director who helps administrators prepare each request to the Executive Committee, we strive to present every request for waiver in its best factual light and every rule involved in its complete educational and historical context.