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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.”

Reality Check

July 7, 2015

The organization I worked for immediately prior to this 29-year run with the MHSAA utilized “harnessed hero worship” as its principal strategy for evangelism. It was generally effective; but because of human frailties, some of the heroes would disappoint us and disrupt the important work.
This experience and others over the years have caused me to, at most, only feign excitement when someone suggests we get this or that “Big Name” to keynote a conference or endorse an initiative. I prefer substance over style, and staying power over shooting stars.
All of this likely made me susceptible to shouting “Right On” when I read the May 14, 2015 blog post of Matt Amaral, a teacher in California. The title: “Dear Steph Curry, Now That You Are MVP, Please Don’t Come Visit My High School.”
Regarding celebrity worship, Mr. Amaral writes that we need less of it.
“Coming to poor high schools like mine isn’t going to help any of these kids out; in fact, it might make things worse.”
Amaral explains that unlike Curry (who is an example and not a target), the students he teaches are not genetic giants and do not have the resources and support that separate the less than one percent from the rest of us. “What you won’t see,” Amaral writes in his “open letter” to Curry, “is the fact that most of these kids don’t have a back-up plan for their dream of being you.”
“They are already very good at dreaming about being rich and famous; what we need them to do is get a little more realistic about what is in their control. We need less of an emphasis on sports and celebrity in high school, because it is hurting these kids too much as it is.”
(You can find more of Mr. Amaral’s provocative thoughts at teach4real.com.)