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.”

No Rules?

February 6, 2018

We like to say that school sports is “educational athletics,” but this does not mean athletics and academics should be treated exactly the same.

Competitive athletics is not like the composition or algebra classroom. Competitive athletics requires two opponents playing by the same rules that govern who can play and how they can play.

In 1907, William James put in writing a series of lectures he had given in Boston the year before titled “Pragmatism: A New Name for Some Old Ways of Thinking.” Included in the third lecture is this gem:

“. . . the aim of a football team is not merely to get the ball to a certain goal (if that were so, they would simply get up on some dark night and place it there), but to get it there by a fixed machinery of conditions – the game’s rules and the opposing players;”


This to James was a given, cited to help him make a more profound point.

But the point here is profound enough for us. Without rules, and opponents playing by the same rules, there is no validity in moving the ball to the goal. Without rules, there is no value in sinking the putt, making the basket, clearing the bar, crossing the finish line. Without a regulatory scheme adhered to by all competitors, victory is hollow.