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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.”

No Easy Fix

February 13, 2015

“If we don’t fix this problem, even our friends and allies may turn against us.”
That was the dire warning one of the MHSAA staff members gave to the rest of us at a weekly staff meeting recently, during which this staff member was receiving emails from people appalled over the mid-season transfer of a basketball player from one school to another.
The “fix” that some people want is a rule that makes every transfer student ineligible for a full year, regardless of the reason for the change of schools or the circumstances of the student. Of course, that rule would never survive judicial scrutiny, and legislators in every corner of the state would be advocating change for the sake of one child or another.
A more moderate remedy is to utilize a rule that applies the full-year period of ineligibility to those students whose circumstances do not fit one of the already established 15 exceptions that make a student eligible without delay following a transfer. That half-measure would not stop many transfers that would still frustrate people, and it would snag many transfers that would continue to anger people.
The rules we already have in place are tools for schools to use to stop many of the transfers that frustrate without snaring those transfers that anger: the athletic-motivated transfer rule and especially the athletic-related transfer rule (or links law).
Before our friends and allies turn their backs on us, they need to turn in the transfer situations where the rules already apply, and the undue influence (recruiting) they can document. They need to give the system a chance to work to the full extent of its potential. We should not make tougher rules if schools fail to utilize the rules they already have.
Adopting rules is usually easy for the organization. Applying rules is often much harder for the schools.