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.”

Questions

September 9, 2014

Sometimes leadership looks at questions as a challenge to its authority, or as a way to obstruct progress. Both can be true.

But a better way to view a good question is as a valuable gift. It can provide an opportunity to learn, to consider details that hadn’t been addressed or alternatives that hadn’t been raised.

And a better way to look at a leader than the one with all the answers is to view the leader as a collector of questions.

The quality of those questions can have a direct relationship on the quality of ideas and initiatives that form, and a direct effect on programs and services that follow.

During August and September, MHSAA Associate Director Tom Rashid has been meeting with athletic administrators at their league meetings. Among several objectives has been to ask these front line administrators to think about some new approaches to some old topics – like out-of-season coaching limitations and policies and programs for junior high/middle school students. He has been asking questions, and then he’s been listening to questions, both of which are preparing us for more in-depth discussions on these topics throughout the remainder of the 2014-15 school year.