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.”

Fixing Schools

August 16, 2013

Our fall sports have begun and, as usual, our good coaches are focusing on fundamentals during these early weeks of practice and play, especially if they are trying to bounce back from some losing seasons. Meanwhile, I’ve been thinking about the fundamentals for fixing schools themselves.

If we really would get serious about a comeback season, we would . . .

  1. Equip the best teachers to work in the worst places.
  2. Provide the highest pay to the teachers working in the lowest grades.
  3. Emphasize   teachers more than technology,
                          pre-Kindergarten more than college prep, and
                          smaller more than larger.
  4. Encourage   fight over flight,
                          tutors over transfers,
                          school improvement over school choice, and
                          investment over vouchers.
  5. And, for Pete’s sake, we would allow public schools to start classes as early as they see fit, even next Monday, not two weeks and a day later as state law mandates. Longer is better than shorter.

And sooner is better than later for putting these fundamentals into our game plan for education.