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.”

Leadership Road

May 22, 2015

Earlier this month, the small portion of Michigan voters who bothered to vote at all resoundingly rejected the so-called road fix – Proposal One. It was no surprise, and provides at least these two leadership lessons.

First, people expect their designated leaders to lead. From everything I’ve read, heard and felt personally, voters were upset that their elected officials could not or would not fix our state’s crumbling roads and bridges. They punted; and the voters punted the ball right back to the people they expect to have the wisdom and will to craft and compromise their way to workable solutions to tough problems.

The second lesson is that people expect straightforward solutions. Again, there is every indication that Proposal One was too complicated and a far more comprehensive package than people could comprehend. By trying to do more than fix roads and bridges, the proposal wasn’t able to get the support needed to do anything at all.

The creativity and courage to prepare and promote the most direct remedy for road repair is a top issue for the State of Michigan. Taxpayers of the state want their elected officials to run an offense to move the ball across the goal line, with little razzle-dazzle and no punts. 

That’s the preferred and probably necessary approach for addressing the major problems of any enterprise, including ours.