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.”

Making an Impact

September 11, 2012

Here’s a provocative statement by David Gergen, professor of public policy and director of the Center for Public Policy at Harvard’s Kennedy School of Government, and a frequent political analyst for CNN:  “The nonprofits making the greatest impacts these days are entrepreneurial, adaptive, outward-looking, and sometimes a little messy.”

I like that, and I think using these four features or criteria to evaluate the MHSAA now and in the mid-range future would be good for those we serve.

  • Are we entrepreneurial?  How could we be more so?
  • Are we adaptive?  Are we flexible in how we do things?

  • Are we outward-looking?  Are we impacting school sports broadly and deeply?  Does the impact have staying power?  Are schools better because of what we do?  Are communities stronger for our doing it?

  • Are we sometimes a little messy?

I suspect that if we are the first three – entrepreneurial, adaptive and outward-looking – then messiness is a natural byproduct.  There will be starts and stops, failures before successes, changes.  There will be disagreements and compromises.

I suspect that we will have to tolerate a little more messiness if we are to move forward, even faster than we have, and if we are to have impact, even greater than we have.