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.”

Values Trump Rules

November 19, 2013

The last two postings, which were about rules and rule-making, have quoted from how:  Why HOW We Do Anything Means Everything by Dov Seidman. The book deserves at least this additional commentary.

Mr. Seidman posits that in the modern world of hyperconnectivity and transparency (which he describes in detail), there is no such thing as “private” behavior. It’s all public and, therefore, how we do things is more important than what we do.

He states that to stand out in a positive way, an enterprise must “outbehave” the competition. And he says, such behaviors do not follow rules, they flow from values.

This means, according to Seidman, that effective leadership in this environment will be less about coercion (rules) and more about inspiration (values). Leaders will spend less time talking about the carrots and sticks of managing people, and more time focusing on “values and missions worthy of their commitment.”

It’s a shift from “task-based jobs” to “values-based missions;” a transformation from “command and control” to “connect and collaborate” leadership. “It’s a move from exerting power over people to generating waves through them.”

Instead of talking about organizations that are too big to fail, Seidman says we will have organizations “that are too sustainable to fail, too principled to fail, and too good to fail.”