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 Imperative of Institutional Control
March 13, 2018
Of the various criticisms about the MHSAA’s handling of transfers, these three have the ring of some validity:
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The Transfer Rule is too complicated.
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The Transfer Rule is poorly understood at the local level, and thus unevenly administered.
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The MHSAA office is ill-equipped to police the transfer scene.
The language of the Transfer Rule has expanded from a few sentences to many pages over its 90-year lifetime. This is the result of changes in schools, sports and society, as well as people operating at the edges of the rule, which has led to a rule that has attempted to cover more circumstances with more specificity year after year.
This increasingly nuanced rule takes both training and time. The MHSAA does an excellent job of providing training online and in person, but local administrators are not putting in the time – they can’t! They are usually less experienced but given more non-sports duties than athletic directors of 10, 15 and 20 years ago; and they are leaving the profession after shorter careers. They often lack the training and time to do the complicated and potentially contentious tasks, including Transfer Rule administration.
Overwhelmed local athletic directors are not shy about contacting the MHSAA office for assistance in interpreting and applying the Transfer Rule. These incoming questions dominate the time of MHSAA staff who have many other duties, including the administration of MHSAA tournaments in 14 sports for each gender.
Lacking sufficient staff time and subpoena power, the MHSAA must depend on local school administrators to police their own programs, communicate with their neighbors, and report what they believe might be violations within their own and nearby programs.
While we keep working on the language of the Transfer Rule, we harbor no illusions that it will become simpler to understand and enforce. That’s just not how the modern world works ... everything becomes more complicated. Which may only make it more unlikely that schools will dedicate the time and talent necessary to assure that the principle of “institutional control” is practiced by MHSAA member schools.
However, if we give up on that principle, no amount of oversight by the MHSAA office will ever be enough to police school sports in Michigan ... not just to monitor transfers, but also to attend to the dozens of other elements that distinguish educational athletics.