Logo

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.”

Researching Reclassification

January 25, 2013

The MHSAA was the first state high school association in the U.S. to divide its member schools into enrollment groups for season-ending tournament play. Over the years, in one form or another, all other statewide associations have done the same; and in more recent years, some have tweaked their systems to facilitate practical considerations of tournament administration or to address demographic or political shifts among their memberships.

Two forces have combined to bring increased attention to the participation of public and nonpublic schools in the same tournaments: 

  • First, as state associations expanded the number of classifications to provide more opportunities for their schools to experience tournament success, the percentage of nonpublic schools winning those championships has increased.  Nonpublic schools rarely won any championships at all before the expansion to multiple classifications and especially to the additional expansion in football classifications.  Public schools are not winning fewer championships today than years ago; they are merely winning a lower percentage of the championships now provided.
  • Second, as state governments have reduced funding to public schools, those schools have been forced to reduce support for their sports programs and more often make them pay-as-you-go, much like nonpublic schools have operated for years.  As pay-for-play and fundraising have been popularized in public schools, their “marketing advantage” over nonpublic schools has been diminished.

Often overlooked by those who call for separate tournaments for public and nonpublic schools is the fact that the majority of nonpublic schools rarely have had any success in statewide tournaments, and some have never had any success at all.  An occasional District championship and a rare Regional trophy is the reality of most MHSAA member schools, both public and nonpublic. This, and the fact that "multipliers" have addressed only nonpublic schools and not also select-enrollment public schools (magnet, charter, choice), explains why MHSAA study groups have rejected the use of an automatic enrollment multiplier for nonpublic schools which is now in use in about 10 states.

Acknowledging the flaws of a multiplier that is applied only to nonpublic schools, a few states have been working with a formula, applied to all schools, that reduces the enrollment figures used for tournament play based on factors that may tend to reduce the percentage of a school’s enrollment likely to participate in sports.  For example, there is limited evidence that students who are on free and reduced lunch participate at a rate that is 10 to 14 percent lower than other students; so this is a factor reducing schools’ tournament enrollments in two states.  A third state association looked at this and decided that the data didn’t justify the effort.

Two other states have recently implemented a system that places schools in a classification for larger schools after they achieve a certain level of tournament success in the classification in which they would normally be placed.  Of course, critics of this type of system that address the “chronically successful” are quick to point out that this does nothing for the school which is successful in the largest classification and tends to “penalize” next year’s students for the success of the previous years’ teams.  Would it be right to force Ithaca High School into a higher classification in football in 2013 because it captured MHSAA titles in 2010, 2011 and 2012?  And what would be done with Detroit Cass Technical after back-to-back titles in Division 1 of the Football Playoffs?

About these topics nationwide, there is much talk, some action, and no consensus.