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.”

More Than A Myth

September 5, 2014

Without a sure sense of what the outcome should be, we are engaging school administrators and others in a year-long discussion of possible revisions in out-of-season coaching rules.
We know that we would like the outcome to be simpler rules that are easier to understand and enforce; and that we would like to permit coaches to spend more time with student-athletes out of season; and that we want none of this to make coaches feel like they must coach one sport year-round to be successful or make student-athletes feel like they must play a single sport year-round just to make the team.
If there is a policy that can accomplish the good that we hope for and avoid the bad that we fear, we haven’t yet found it or developed it.
There is a temptation to characterize the multi-sport athlete as an anachronism or myth of modern school sports. However, the multi-sport athlete remains the backbone of interscholastic athletic programs in Class C and D schools.
And the multi-sport athlete still appears to be the ideal athlete, regardless of school size. It is an instructive reminder, I think, that the Lansing State Journal named a three-sport star from Ithaca as its high school male athlete of the year for 2013-14, and it was a four-sport athlete from Eaton Rapids who was named the high school female athlete of the year.
Following my presentation to coaches, student-athletes and parents at Jonesville High School last month, a student approached me to offer thanks for our sponsoring bowling. Jonesville won the MHSAA’s 2014 Division 4 Boys Bowling championship; and the young man who thanked me participates in football, bowling and baseball for his school, representing in my mind the kind of student we should strive the hardest to serve as we develop, revisit and revise policies and programs.