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.”

Staying the Course

August 7, 2015

During my first days on this job 30 years ago this week, I told the MHSAA staff, interviewers and constituents that from my first week on the job to my last, there would be four fundamental issues which would continuously have our attention. Different problems, trends and fads would come and go; but we would remain faithful to these four topics:
  • Scholarship – meaning scholarship in high school, not athletic scholarships to college; maintaining school sports as a helper to the schools’ academic mission.
  • Sportsmanship – meaning the environment at interscholastic events, shaped by the attitudes and actions of players, coaches and spectators; seeing good sportsmanship as a precursor to good citizenship.
  • Safety – assuring parents that their children not only will be as safe as possible in school sports, but will develop habits that tend to encourage a lifetime of better health.
  • Scope – placing borders around school sports that tend to assure a sane and sensible, student-centered educational experience.

I said in 1986 that these would still be our top topics in 1996, 2006 and 2016; and the “Four S’s” have stood the test of time. In fact, they stand even taller now than three decades ago.

On Monday, the first day of this 30th year, 95 representatives of 70 schools gathered for training to execute one of two pilot programs we have launched for 2015-16 to improve the process of concussion detection at interscholastic practices and contests.

When fall practices begin next week, they will do so with three other health and safety changes.

  • All member schools, grades 7 through 12, must report all suspected concussions at practices and games to the MHSAA, utilizing a web-based reporting system on MHSAA.com.
  • All high school varsity head coaches must have a current certification in CPR.
  • All athletes in all levels of all sports in MHSAA member schools grades 7 through 12 will be provided, without charge to either their families or the schools, concussion care insurance aimed at assuring all students have access to prompt, professional medical care, regardless of family resources.