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.”
Specialization Risks
July 21, 2014
Another informed and influential voice has joined our frequent refrain that sports specialization is rarely in a student’s best interest.
David Epstein, author of The Sports Gene, offered an opinion piece for the New York Times last month that “hyper-specialization . . . is both dangerous and counterproductive.”
Epstein described the results of a three-year study at Loyola University of Chicago that found highly specialized youth had a 36 percent increased risk of suffering a serious overuse injury, including “stress fractures in their backs, arms and legs; damage to elbow ligaments; and cracks in the cartilage in their joints.”
Epstein continued: “Because families with greater financial resources were better able to facilitate the travel and private coaching that specialization requires, socio-economic status turned up as a positive predictor of serious injury.”
“In case health risks alone aren't reason enough for parents to ignore the siren call of specialization,” wrote Epstein, “diversification also provides performance benefits.” He cited “better learning of motor and anticipatory skills – the unconscious ability to read bodies and game situations – to other sports. They take less time to master the sport they ultimately choose.”