Why the study?
Controversy exists over the use of electrocardiograms in sports pre-participation screening.
Does 12-lead ECG screening improve the detection of cardiac disease and sudden cardiac death-associated conditions in young athletes compared to history and physical examination?
Does 12-lead ECG screening improve the detection of cardiac disease and sudden cardiac death-associated conditions in young athletes compared to history and physical examination?
A 12-lead ECG is significantly more effective than history and physical examination alone for detecting cardiac diseases and conditions associated with sudden cardiac death in young athletes.
Answers are grounded in this paper and cite their sources.
ECG screening should supplant H&P alone for preparticipation athlete evaluation; confirms markedly superior detection of cardiac disease and SCD-associated conditions.
Controversy exists over the use of electrocardiograms (ECGs) in sports pre-participation screening. We performed a meta-analysis comparing the effectiveness of history and physical examination (H&P) with ECG at detecting both cardiac disease and sudden cardiac death–associated conditions (SCD-AC). Pre-participation studies published from 2015 to 2020 with athletes 10 to 35 years old were included. This yielded 28 011 athletes screened and 124 cardiac diagnoses, 103 of which were SCD-AC. A meta-analysis of log odds ratios (ORs) was conducted using a random-effects model. The ORs for the association between H&P and detecting both cardiac disease and SCD-AC were not statistically significant (OR = 3.4, P = .076; OR = 2.9, P = .078). The ORs for the association between ECG and detecting both cardiac disease and SCD-AC were statistically significant (60, P < .001; 148, P < .0001). In conclusion, the odds of detecting both cardiac disease and conditions related to SCD with ECG are greater than with H&P during sports pre-participation screening.
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Goff et al. (2023) studied this question.
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