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.”
Don’t Look Back
November 23, 2011
In August of 1986, at the end of the one week of overlap between the previous MHSAA executive director, Vern Norris, and the start of my tenure, I found an envelope on my desk from Mr. Norris that read: “No words of advice. Just make your decisions and don’t look back.” That’s Lesson No. 5 of six in this series of blogs.
In our work, time is of the essence. We don’t have the luxury of long deliberations. The next game may be today; the next round of the tournament tomorrow.
In our work, staff is limited. We don’t have subpoena power. We have few staff spread thinly over many responsibilities.
In our work, because it’s in a competitive arena, people are sometimes disingenuous. Some have personal agendas, impure motives sometimes. They care who wins and loses; we don’t.
And most people have miserable memories. I’m skeptical that people recall well the details of events; and people are even worse when recalling details of conversations.
So, in our work, we make one more call and then, with good intentions and reliance on rules, we get on with the decision and try not to look back.
It’s hard to do, but a good deal healthier if we can.