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.”

Fewer but Bigger Changes

June 22, 2015

Accelerating a nearly decade-long trend, there was a sharp decline in the number of sport-specific proposals from MHSAA committees to the Representative Council during 2014-15 – in fact, the smallest number of recommendations for change in more than 30 years.
The dearth of proposals from some sports means all is well; however, for other sports, it only means that proposals to effect some major changes were not yet ready for prime time. For example, several sport communities are interested in seeding some aspects of their MHSAA tournaments, but they have a lot more work to do to draft the details and to develop broad support within their sport across Michigan.

The Representative Council has taken advantage of the repose to advance policies that extend across multiple sports and years. For example ...

  • The three-year phase-in of additional health and safety requirements for coaches. The second step – CPR certification for all high school varsity head coaches – commences Aug. 1, 2015. The third step – that all high school varsity coaches hired for the first time in Michigan after July 31, 2016, complete the Coaches Advancement Program Level 1 or 2 – takes effect with the 2016-17 school year.

  • The focus on concussion care in both practices and events of all levels of all sports. School year 2015-16 brings new reporting and recordkeeping requirements for member schools, as well as MHSAA-provided medical insurance protection for all eligible athletes, grades 7 through 12.

  • Changing out-of-season coaching rules. While the membership didn’t rally toward a totally new approach during the past year’s discussions, consensus did coalesce around four substantive changes to the current approach to manage and monitor out-of-season coaching, which the Council approved to take effect in 2015-16.

  • The proposed amendment to allow school membership in the MHSAA to begin with the 6th grade. Discussion on this topic resumed two years ago and it will continue through constituent meetings this summer and fall prior to the membership’s vote in late October. The change, if approved, would take effect Aug. 1, 2016.