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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.”

See the Whole Play

August 19, 2014

“What I Learned from That Play” was the name given to a session at the National Association of Sports Officials (NASO) Summit in Albuquerque last month. Several prominent officials talked about tough calls they made. One official was telling us of an error made, the other of a correct call; but the message was the same from both: “See the whole play.”
One official described an apparent touchdown reception where the focus of the officials was intent upon whether or not the receiver had a foot inbounds and maintained possession of the ball. Both occurred, but all the officials missed the fact that the receiver’s foot had brushed the pylon at the goal line, which made the pass incomplete regardless of what followed. “In focusing so intently on two key aspects of the play, we missed a detail that overruled the other two.”
“To make the right call we have to avoid narrow focus and be aware of all details,” this college official opined.
The other official described a play in which the quarterback rolled to his left to throw a pass while linemen provided protection. There was a near chop block by the left guard and running back, near hold by the right tackle, and a center/guard double team that had to be observed closely. But there were no penalties called, correctly according to the video the audience was shown.
The play ended with the quarterback heaving a forward pass just as he was being tackled. The referee called him down by contact, before the pass; and the video showed that call to also be correct.
The referee said: “If the officials had fixated on the double team, or the potential hold or the possible chop block, the crew may have missed that the quarterback was down by contact for a seven-yard loss.”
Each official was speaking of the importance of seeing the whole play – all of the key factors. Staying open to all the details.
Game officials must do this over the span of a few seconds or less, but countless times over the course of a contest. Administrators have the luxury of minutes, days, weeks or longer to get it right.

Here are a few more pearls of wisdom from the nation’s leading gathering of sports officials, these from Barry Mano, NASO president:

  • “Incorrect no-calls are easier to explain than incorrect calls.”
  • “Officials are to enforce, not appease.”
  • “In spite of their criticisms, there is no sensible parent who would want their child to participate without officials.”