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.”
Official Feedback
June 10, 2014
We receive much unsolicited comment about the performances of officials and the conduct of spectators. Here’s some of what the MHSAA does to actively solicit input from its key constituents.
Since 1956, the MHSAA has required member schools to provide numerical ratings of officials who work their contests. Since 1998, the system has also allowed schools to cite particular areas of perceived weakness; and doing so is required whenever a school provides a rating of “5” (worst) on the 1-to-5 scale.
There are many deficiencies in a system like this, including that it sometimes means that coaches or administrators are doing the rating, and some of them have never officiated and may not know the rules and mechanics as well as the officials. The rating can also be affected by whether the school won or lost.
Nevertheless, the system has value, not as a true evaluation of an official’s performance for any particular contest, but – when the ratings of all schools are combined over a three-year average – as a number that the official can use to understand his or her abilities relative to all other officials. And it’s a number the MHSAA can use, along with recommendations of local officials associations and assigners, when considering assignments to various levels of MHSAA tournaments.
It is also noteworthy that for 25 years, the MHSAA has used a reporting form allowed in some cases and required in others, whereby officials report unusual events to the MHSAA office immediately after contests. During a typical fall season, about 300 such reports will be filed; about 250 each winter season; about 200 each spring season. Any school which receives three or more negative reports over three seasons receives a letter of concern from the MHSAA and the school’s name is published in benchmarks; and any school that receives no such reports over three seasons receives a letter of praise.
In 2008-09, the MHSAA also began a program whereby officials could rate school sportsmanship. During the winter season of 2013-14, there were approximately 4,000 reports filed, including 2,400 in basketball. The Basketball Coaches Association of Michigan honors the best 100 schools where BCAM members are coaching.