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.”
Students of Rules
November 12, 2013
Those who make rules ought to be students of rules. We mean this in at least the two ways this posting and the next will address.
First, rule makers should know the essence of the existing body of rules which they will be responsible for upholding or modifying during the necessary ongoing review of those rules. These rule makers should have a general awareness of when and why each rule was first adopted, how it might have evolved, how it is now applied and what the major compliance problems have been in the past or may be in the future.
This first requirement is as important for those who prepare the rules for the contests – the playing rules – as for those who promulgate the rules that establish the minimum eligibility standards and the maximum limits for competition. In the face of any proposal to eliminate or greatly modify any rule, rule makers must ask what problems may return if they remove the rule that solved those problems.
Dov Seidman writes in how: Why HOW We Do Anything Means Everything: “Rules, of course, don’t come out of thin air. Legislatures and organizations adopt them usually to proscribe unwanted behaviors but typically in reaction to events. They lower speed limits after automobile accidents become too frequent, regulate pit bulls after a series of dog bites, or institute new expense-tracking procedures after someone is caught trying to get reimbursed for their new iPod. Rules have been established for a reason, but most people are out of touch with the rationale and spirit of why. They don’t read legislative histories and so have a thin, superficial relationship to the rules . . .”
That is not acceptable for those who write, review and revise rules. They have to know where each rule has come from. This is why for the rule makers and for those in our member schools responsible for applying the rules day in and day out, the MHSAA keeps current “The The History, Rationale and Application of the Essential Eligibility Regulations High School Athletics in Michigan."