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.”
Internal Medicine
March 20, 2018
When I express concerns for the health of high school basketball, I’m not confusing our problems with the corruption of major college men’s basketball that is under investigation by the Federal Bureau of Investigation. Yes, there are some tentacles that reach us, and taint us; but the problems that plague us most are more basic and local.
The concerns I have for high school basketball are captured in scenes that play out much too often across the membership of the Michigan High School Athletic Association. For example:
- Declining participation, with JV and varsity rosters too small to practice 5-on-5 at either level.
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Increasing forfeits.
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Ugly mismatches, with scores so lopsided that it is hard to imagine much teaching or learning can occur.
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Starters transferring; reserves dropping out.
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Confrontations between parents and coaches.
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Faculty coaches becoming a vanishing breed.
These kinds of concerns do not flow from the top down – we can’t blame these issues on the NCAA and NBA. No, our more persistent and perplexing problems percolate up from the youth level.
Often the students who come to our programs have participated in youth sports programs for five to 10 years before they join a school team. They arrive with expectations that often differ from what is intended for school-based programs. They’ve been in a different environment; they have different expectations.
And much of what is coming with youth sports begins to infect school sports.
There is no vaccination that will be 100 percent effective in immunizing us. There is no single solution that can quickly reverse these negative trends in school-based basketball and other school sports. The efforts must be systemic and long-term. And among the efforts that must be made are these
- More attention to coaches education – every coach, every year – where the ethics of educational athletics and the meaning of success in school sports provide the core of the curriculum; and
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More attention to junior high/middle schools – more opportunities for 6th- through 8th-graders to sample school sports and to savor an experience that puts team before individual and learning ahead of winning.