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.”

NFL Misdirection

September 26, 2014

NFL Commissioner Roger Goodell did something I really respect; and then he didn’t.
On Aug. 28, the commissioner sent a letter to the NFL’s 32 owners in which he admitted that he “didn’t get it right” when he assessed a mere two-game suspension for a player who was seen on videotape to be involved in domestic abuse. I admire his admission. (The player later would be suspended indefinitely from the league following additional evidence in the incident)
Unfortunately, the commissioner accompanied his mea culpa by describing a series of initiatives the league will undertake, one of which – once again – attempts to deflect a public relations disaster upon high schools.
When the NFL was under attack for the head trauma its players were experiencing, the league responded with a state-by-state campaign to impose youth concussion laws which, in most places, were mostly unfunded mandates that are more about symbolism than substance.
Now, again under attack for malfeasance by a workforce with more money than maturity, the league’s leadership is deflecting the blame to college, high school and youth football programs by planning educational efforts aimed at those levels.
Commissioner! Clean up your mess, but leave us alone. You are gutting public support of school sports with one televised game Thursday, three on Sunday and another on Monday, and adding Saturday games in December. Don’t have this out-of-control league lecture our level about restraint and responsibility.
Ours is the level that prohibits sack dances and end zone prances. We insist that our interscholastic players demonstrate maturity that the NFL’s players do not.