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.”
Mission Control
May 5, 2015
As we survey all that might be done in the future to improve the health and safety of student-athletes, it is good discipline to look to the past and recall when hype or hysteria caused well-intentioned people, and some not-so-well-intentioned people, to campaign for solutions to problems that either did not exist or could not be effectively addressed through mandates on school sports.
Over the years, school sports has been asked to address much more than what occurs on the practice or playing field. We’ve been asked to address drunk and then distracted driving; bulimia and bullying; texting and sexting; hazing and homelessness; seat belt use and steroids, which provides a perfect example of the limitations of fixing societal problems through mandates on school sports programs.
After more than a decade of voluntary educational efforts and just about the time when steroid use in schools began to trend downward, state legislatures caught wind of the “problem” and perhaps of potential political gain.
The University of Michigan Institute for Social Research reports that steroid use has been declining since 2005, which was just before the first state – New Jersey – enacted a law requiring schools to test high school athletes. Undaunted, the Texas legislature followed suit three years later. Undeterred, the Florida legislature followed the next year, and then Illinois lawmakers acted.
Florida discontinued its mandated drug testing program after just one year, and Texas is about to end its program, after spending nearly $10 million. Florida conducted 600 tests. Texas ran more than 60,000. Florida had one positive test. Texas reported less than one percent positive tests.
Because leaders of school sports have the statistics to link sports participation with improved attendance, achievement and attitude at school, we make our programs vulnerable to assault by passionate people who want our good programs to fix their bad problems. We have to be careful to avoid a situation where, in trying to address so many of society’s problems, we actually solve none; and worse, become distracted from our core chore of conducting safe, fair and sportsmanlike programs that make schools a happier, healthier place for student academic achievement.