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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.”

Tasks Before Us

May 20, 2014

A year ago the MHSAA convened the first of several task forces that are tackling the kind of complicated topics on which our annual committee meeting process seemed incapable of making sufficient progress.

We assembled a 16-member task force that met four times over six months during 2013 to develop policy proposals to enhance acclimatization and reduce head-to-head contact in football practices. Meeting multiple times, the group could delve more deeply into data and explore emerging trends in both school-based and non-school football. The task force would develop ideas at one meeting, test them with constituents for a few weeks and then tweak the ideas at the next meetings. Task force members had the time to be both philosophical and practical, to think about what would be ideal and then trim that idea to be workable in all sorts and sizes of schools across Michigan.

As a result of this focused, multi-session approach, the Football Practice Proposals sailed smoothly through a vetting process during the winter months, earned the MHSAA Representative Council’s approval in March and will be controlling MHSAA member school football practices this fall.

Meanwhile, we began 2014 with the appointment of another task force to tackle many thorny issues related to junior high/middle schools. Some of the issues are so fundamental that changes in the MHSAA Constitution could be required to change what the MHSAA should be doing with respect to school sports prior to the 9th grade. There is equal chance that the task force could propose some very large changes, or very little change. We don’t prescribe the result, we just provide the forum and facilitation – create focus that has been lacking for too long.

Later this year and during 2015 we see the likelihood that additional task forces will address other tough topics, like out-of-season coaching, redefining what subvarsity means, and possibly address more risk management issues, perhaps in ice hockey and soccer first and then other sports where health and safety questions are raised.