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Clearing Kids for Sports Participation Sparks Conflicts
Date:9/10/2010

are going to screen, it has to be comprehensive," Dr. Theodore Abraham, an associate professor at Hopkins' School of Medicine and its Heart and Vascular Institute, said in a prepared statement.

Other studies have found pros and cons to extra screening.

For instance, Harvard researchers who looked at 510 college athletes found that screening with a history and physical exam alone has an overall sensitivity of 45.5 percent, meaning it would find existing problems in about 45 of every 100 athletes screened. But adding an EKG to the screening boosted it to more than 90 percent.

However, the EKGs were also linked with a false-positive rate -- suggesting a problem when none existed -- of nearly 17 percent, according to their report, published March 2 in the Annals of Internal Medicine.

A separate study in that issue, on the cost-effectiveness of such screenings, reported that adding EKGs to screenings of young athletes saves two years of life per every 1,000 athletes, at a per-athlete cost of $89.

Screening policies differ from region to region across the country. In Houston, for instance, athletic trainers at 10 high schools are using laptop systems to give young athletes EKGs, and a doctor in the city has launched a program to provide heart screening to all sixth-graders, eventually hoping to screen all sixth-graders in Texas.

But there are downsides to such universal screening, others say.

"About 10 percent of kids who get EKGs are thought to have something the matter with them by the EKG," Thompson, the Connecticut doctor, said. "That drives additional testing, and nearly all don't have anything wrong."

The problem, he said, is not just wasted health-care dollars but the anxiety caused by additional testing, for athletes and their parents.

Thompson said he is not oblivious to parental worry or to the sad reality that some athletes die unexpectedly each year.

"Every single one of these deaths is an in
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