HealthDay News – There is no solid evidence for the effectiveness of pre-participation screening in reducing the number of sudden cardiac deaths among young athletes, according to an analysis published online April 20 in The BMJ.
Hans Van Brabandt, MD, PhD, from the Belgian Health Care Knowledge Center in Brussels, and colleagues discussed the potential harms and benefits of pre-participation screening for reducing the number of sudden cardiac deaths in young athletes.
Researchers found that very few people at risk for sudden cardiac death were identified with the most basic type of screening, comprising medical history in combination with a physical examination, as recommended by the American Heart Association. Increasing diagnostic yield by including a resting electrocardiogram has a sensitivity of 0.75. Screening may also lead to false positives, with specificity ranging from 0.70 to 0.95 in a small case series.
To examine whether screening can reduce the number of sudden cardiac deaths in young athletes requires a randomized controlled study, although no such study exists. A population-based study from Italy suggested reduced incidence of sudden cardiac death with screening, although the data need to be fully analyzed to identify causality. Screening is also associated with certain risks, including the need for additional testing, which may cause anxiety and psychological harm.
“As long as those at high risk of sudden death cannot reliably be identified and appropriately managed, young athletes should not be submitted to pre-participation screening,” the authors wrote.
Van Brabandt H, Desomer A, Gerkens S, Neyt M. Harms and benefits of screening young people to prevent sudden cardiac death. BMJ. 2016;353. doi: 10.1136/bmj.i1156.