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.”

Permission to Disagree

February 17, 2015

An organization leader who is doing a good job works hard to provide the organization’s board of directors all the history and detail necessary to make good decisions. Questions and concerns are anticipated, and addressed in advance.
As a result of this good leadership, meetings usually run with efficiency, decisions are made without long discussions, and debate is infrequent and never contentious. Votes usually reflect unanimous agreement.
While these are traits of good organizational leadership, a tradition of great organizational dynamics is disagreement.
If the board is always in total agreement, then management is not bringing the board tough enough topics. The subjects are not serious enough. They are operational more than strategic; they are transactional, not transformational.
Among the current topics of school sports in Michigan are two upon which there is certain to be disagreement: (1) the role of 6th-graders in school sports and the MHSAA; and (2) out-of-season coaching rules. We see the lack of consensus at the local level and the league level and between different coaches associations. And we expect the Representative Council will lack unanimity if these topics ever arrive for the Council’s action.
These are large topics, worthy of our time because of the disagreement, not in spite of it.