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.”

Who’s Listening?

August 1, 2014

In an organization as diverse as this one, including that some schools are located more than a 10-hour drive from others and some schools are 100 times larger than others, differences of opinion about policies, procedures and programs are inevitable – and so are complaints about the decisions the organization makes.

One of the criticisms that decision-makers can count on from constituents is that they don’t listen well to or consult adequately with those affected by their decisions. Generally, such criticism comes from those who favored a different decision. They complain about the process when it’s really the result of the process that bothers them.

From where I sit, sometimes the target of such criticism, I often wonder if the pot is calling the kettle black. I wonder if the critics are listening attentively or at all to their own constituents. For example: 

  • While a significant minority of school administrators complain of the burdens of the MHSAA’s increasing requirements for coaches education focused on health and safety, nearly 100 percent of their parents want even more than the MHSAA is mandating – they want what we’re requiring sooner than we are requiring it, and they want even more required.
  • While it’s only slightly more than half of school administrators who want the MHSAA’s role and authority to begin before the 7th grade and want schools running those younger grade level sports programs, nearly 100 percent of students and their parents want these things to happen, and they have for a long time.

When I bring these two topics up to students or speak to local parent groups or county school board associations, I can count on getting an earful of impatient suggestions.

So while some school administrators might complain that the MHSAA isn’t listening well enough to them, I wonder if those critics are listening well enough to their own constituents.