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.”
The Goldilocks Solution
December 2, 2014
Somewhere I read that there’s little to gain by trying to bring simplicity to what’s complex or sanity to what’s crazy. But we keep trying.
Last month we compiled results of a survey through which 513 MHSAA member high school athletic directors provided information about the out-of-season activities of their students and coaches and offered opinions regarding ideas to modify the rules that control those who want to do so much that it would force others to do more than they believe is sane for school-sponsored, student-centered competitive athletic programs.
A nearly equal number of schools from each classification were included in the 513 schools that responded to this opportunity to add more information and insight to this year-long look at MHSAA out-of-season coaching rules.
Some preliminary number crunching reveals (without surprise) that there are differences between large schools vs. small and more populated areas vs. less – differences both in the amount of organized out-of-season sports activity in which students engage and in the openness of their athletic directors to new ideas for regulating out-of-season activities by students with their school coaches. Generally, larger schools and/or schools in more populous areas see students participating in more organized out-of-season athletic activities, and they are more open to changing how those activities are regulated.
And so it continues ... finding that sweet spot that fits the perspectives and problems of a very diverse membership that supervises a wide variety of sports. The “Goldilocks” solution that doesn’t do too much, or too little.
The results that I’ll be looking for as we continue to gather information and facilitate discussions is no specific set of rule changes, but rather, to move MHSAA policies and procedures toward these two goals:
- Rules simpler to understand, follow and enforce. Even good rules are bad if they are too cumbersome.
- Rules that do not add pressure on students or coaches to focus on a single sport year-round. There is plenty of data that informs us that parents do too much of that already.