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.”
Urgency
November 8, 2011
I still have in my files and in my mind Joe Klein’s Newsweek editorial of Sept. 21, 1992, that took Bill Clinton to task for his “small themes” during the closing months of his campaign for the U.S. presidency.
Never one to be shy in his bully pulpit at Newsweek (or in his then anonymously published novel Primary Colors based on the 1992 Democratic presidential primary), Klein wrote that Clinton’s late campaign efforts were “rhetorically flaccid, intellectually unadventurous, morally undemanding.”
In response, Clinton’s campaign strategist, James Carville, resorted to a sports metaphor: “The way to the goal line is to keep running off tackle. Four yards and a cloud of dust.”
This “take no chances, do no harm, run out the clock” spirit and strategy that so infuriated Klein will not be seen at the MHSAA. Expectations and efforts will be in continuous crescendo no matter how close the goal line gets. In fact, as it is with any good football team in the “red zone,” the closer the goal line looms, the greater the sense of urgency there will be.
There is no greater proof at this moment to our most inner circle of constituents – high school athletics directors – than the MHSAA’s work with ArbiterSports to become the first state high school association in America to develop, and to deliver at least initially at no cost to all member high schools, a comprehensive suite of electronic tools for athletic department administration. This is a responsibility, and risk, that could have been left to others; but we’re being motivated by undertaking the task here and now – first in the nation – so that the product is tailor-made for high school sports, Michigan’s way.