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.”

Committee Work

January 6, 2015

The winter months are the busiest for MHSAA committees, especially for those that must review or prepare recommendations for changes for the following school year.
Each year, up to 20 MHSAA committees consider proposals for Representative Council action relative to MHSAA tournament policies or procedures or Handbook regulations or interpretations.
During school year 2014-15, wherever applicable, the committees are being asked to address health and safety issues as well as policies and procedures relative to subvarsity and junior high/middle school students; and as a result of positive 2014 Update Meeting Opinion Poll responses, each sport committee is being asked to respond during calendar year 2015 and beyond to several concepts for MHSAA tournament seeding.
MHSAA committees are dominated by coaches, but they are not a rubber stamp for proposals that proceed from that sport’s high school coaches association. The difference of opinion often results from the committee seeing things differently than a coaches association leadership that the committee believes is not representative of schools of diverse size, location and demographics.
It is appropriate for committees to ask: Who was not in the room when this recommendation was drafted? Who will not be served well by this change?
When committees go through this process, they tend to reduce the quantity but improve the quality of recommendations to the Representative Council, which increases the percentage of recommendations the Council adopts.