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.”

Stacking

December 19, 2014

Many in the interscholastic tennis community of this state have complained for years about the unethical practices of a small number of coaches who “stack” their lineups so that their better players compete in lower flights to increase their chances of success in advancing and earning points for their teams.
The current meet scoring system, which fails to reward teams for placing players at the highest levels, invites the problem. Appealing to personal integrity works with most coaches, but not all; so the issue of stacking festers, and it frustrates many coaches.
Hearing this pain, in 2009 the MHSAA convened a group of tennis coaches to discuss stacking. We utilized a paid professional facilitator. One obvious outcome was very little support to solve the problem by restructuring the tennis meet scoring system to disincentivize stacking.
The simple solution – to modify the meet scoring system to provide more team points for Number 1 singles than Number 2, and for Number 2 more than Number 3, etc. – was a double fault with the clear majority of the coaches assembled in 2009.
Of course, simple solutions rarely are so simple. And with this scoring system solution comes the likelihood that stronger teams move even further out of reach of their challengers. Other critics are uncomfortable with giving one student-athlete a higher potential team point value than another.
If those and other objections are the prevailing sentiment, then a new scoring system won’t be in our future. And stacking still will be.