Cardiac Screening
October 31, 2014
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.”
One Concussion Conclusion
August 25, 2017
After both the first and second years of collecting head injury reports from all Michigan High School Athletic Association member high schools for all practices and events in MHSAA sports, we cautioned people to refrain from making too many conclusions.
It’s too soon. We now have a baseline, but we will need several years before we can be certain that we’ve spotted trends or trouble spots.
Nevertheless, one observation screams out. Girls report two to three times the number of concussions that boys do. In basketball, soccer, and in softball compared to baseball, girls report two to three times as many concussions. That was true in year one; it remained true in year two.
It may be that girls sustain more concussions than boys, or that girls are more forthcoming in reporting than boys are, or both. In the past, researchers have published both conclusions.
In either case, it means we need to coach boys and girls differently, and we need to prepare coaches differently for boys and girls teams, as we are doing in the MHSAA Coaches Advancement Program.