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.”

An Unsustainable Trend

February 10, 2015

Decades ago there was much criticism from college and university physical education departments that schools were sacrificing broad-based programs of intramurals and recreation for higher-profile programs of interscholastic sports teams.

Today, broad-based intramural/recreational programs have all but vanished from schools; and the criticism now is that elite community club and travel teams threaten the broad and deep interscholastic athletic program schools have been providing students.

In my lifetime, I’ve seen the image of school sports go from elitist to egalitarian. From a few sports teams for boys in the 1950s, to teams on multiple levels in many sports for both boys and girls today.

Over the same period when the public profile of school sports has been diminished by many societal trends but especially the ascendancy of major college and professional sports riding the proliferation of television sets and rising profits from sports broadcasts, the breadth and depth of school sports was busy expanding the circle for which it provides opportunities to play.

The irony is that in this time of school sports’ greatest inclusion, school sports is on its weakest financial footing. When it is doing the most, school sports is being supported the least.

It’s an indefensible, unsustainable trend that must be addressed by those who control the purse strings of state government and local school districts.