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.”
Considering the Unrepresented
November 22, 2011
When I interviewed for the job of MHSAA executive director in the spring of 1986, I was asked about my administrative philosophies and approaches to problem solving. I don’t recall now all I said then, but I do clearly remember saying I would “err in favor of kids.” I meant that, when a difficult situation presented an unclear choice, I would give the benefit of doubt to kids.
That was somewhat naïve, I suppose; but I still do bring that mindset to situations that appear to be a toss-up.
Over the years I’ve stumbled upon or consciously cultivated other lessons for myself, and I have shared some of them with my dedicated colleagues at the MHSAA. Of many, here’s the first of six (the other five will be presented in subsequent blogs): Consider those not in the room or not at the table.
When people propose a change in a rule, consider where they are coming from, and consider those who are not present who may have different circumstances, perspectives and needs.
If the proposal is from large schools, consider how it might affect small schools. If from southern schools, how it might affect northern schools. If from suburban schools, how it might affect urban or rural. If from football coaches, how it might affect other sports; if from a winter sport, how it might affect fall or spring sports.
When people seek from the Executive Committee waiver of a particular rule on behalf of one student, ask how that waiver would affect those not present against whom this student would compete.
When someone seeks relief from a penalty, ask how that will affect those not present, including those who have received the penalty in the past or should receive the penalty in the future.
Considering those who are not in the room who may be affected by a proposal by those who are in the room has been a gift given to me by Keith Eldred of Williamston who served on the Representative Council over 25 years ending in 2008.