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.”
One More Call
November 23, 2011
This blog continues with lessons learned on my highly motivating but sometimes hot seat at the MHSAA. It’s Lesson No. 4: Make one more call.
Not 100 percent of the time, but well over 50 percent of the time, if I had made one more call before making or communicating a tough decision, either the decision would have been different or, more often, the decision would have been received better.
Obviously there are limits to this. There always could be one more call. But it has become a “Roberts Rule of Order” anyway to make one more call. For I can trace an inordinate percentage of wrong decisions, or bad reactions to correct decisions, to not making one more call.
More often than not on difficult decisions, I work in tandem with other MHSAA staff and especially Associate Director Tom Rashid who now routinely makes that one more call. It has improved both our decisions and communications.