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.”
A Backhanded Compliment
April 17, 2012
A year ago this month I listened to the attorney for another statewide high school athletic association pose this question: “Why is it that people quite readily accept inflexible age limitations over a broad spectrum of American life, including sports, but presuppose it is wrong for school sports?”
This attorney was in the middle of a controversy that more recently has visited the MHSAA: an overage student seeking relief from a universally applied maximum age rule. The speaker was perplexed and frustrated by the double standard.
Part of the reason for the double standard rests in the reality that people value the school sports experience so much more than other parts of life, including other sports experiences. Because they want the opportunity to play, they resort to litigation in an attempt to create the right to play.
Another part of the reason school sports is challenged on an issue on which other programs get a free pass is that school sports has a centralized authority, close to home. State high school associations are readily accessible targets, easier both to find and to fight with than most other entities with age restrictions.
And, of course, part of the reason for the double standard is the proximity of interscholastic athletics to academics – the former extracurricular, the latter curricular – the former a privilege for most teenagers, the latter a right of all citizens to age 26.
The reasons school sports are attacked on this issue while other entities are not are reasons really complimentary to school sports: the program is popular, accessible and connected to education. None of these features of school sports, or its age limitation, should change.