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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.”

Innovation Obstacles

April 12, 2013

It doesn’t take long to compile a dozen or more examples of products or businesses that have disappeared, or nearly so, because the world changed while the product or business did not.

Think eight-track tapes and players.  Consider what digital photography has done, from the Eastman Kodak Company to out-of-business local studios.  What the Internet has done to travel agents.  See what’s happened and still happening to print newspapers across the country, to magazines, and to both local and large chain bookstores.

It is not at all rare that businesses fail to reinvent themselves.  For many reasons, including admirable passion for what they are doing, business leaders often miss the trends or ignore the signs that suggest the need to change their products or their entire business model.

As Geoff Colvin wrote in FORTUNE magazine Feb. 25, 2013, “Business model innovation is a competency that doesn’t exist in most companies.”  He continued:  “The largest obstacles will be weak imaginations, threatened interests, and culture.”

I suspect that those are also the three major obstacles we must overcome as we think about the future of interscholastic athletics.

  • Does school-based sports, with a 100-year-old history, have a 50 or even 15 year future in schools and society?

  • If so, should the business model change?  And if so, how?

I suspect that some of what we think is change may be no better than rotating bald tires on our car; when what we really need is new tires, or no tires at all.