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.”
FBI Tips
July 14, 2014
In a June 9, 2014 National Public Radio story about the first nine months of James B. Comey’s 10-year term as FBI director, two leadership tips emerged that may apply to all types of organizations.
The first is that since the 9/11 tragedy, the FBI has had to change from an agency created to catch bank robbers to an agency that prevents crime before it occurs.
While all comparisons pale next to 9/11, many organizations have had some kind of crisis that demonstrates dramatically that the organization must change fundamentally in order to serve its overarching purpose in a changing world.
It requires an entirely different mindset, perhaps, an entirely reordered set of priorities.
The second point raised in the interview, and very likely the key to accomplishing the first, is that the FBI is now focused on the biggest steps, not just the easiest ones. This is what Director Comey sees is necessary for the FBI to become the agency our nation needs in today’s world.
The required response to a defining-moment crisis cannot be cosmetic change, but must be almost genetic change. Hard change – a focus on deep, systemic issues, not superficial matters.
It requires an entirely different level of commitment than existed before.