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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.”

Rocket Science

January 5, 2015

I have always been fascinated by space exploration and in awe of all that is required and must go right to send a space vehicle atop a multi-stage booster rocket from a moving object like Earth, and land it softly on another moving object like the moon or Mars or most recently a massive rock, after a journey of many months and millions of miles. How can people figure that stuff out?
There cannot be a problem of school sports that is more complicated than those of space exploration, except for one feature – which is that our problems deal with people, who are far less predictable and dependable than the laws of physics.
Making matters worse is that we are working with people in a competitive arena, and in an emotional setting, where the objectivity which characterizes the scientific method of rocket scientists is generally if not universally absent.
As long as potential problem-solvers view potential solutions through the lens of what does or does not benefit them in terms of competitive edge, our efforts to make good changes will never launch or, if launched, will miss the target.