Why the study?
Pre-participation screening algorithms (PPSAs) based on self-administered questionnaires assess sports eligibility, but their accuracy in detecting medical and CV abnormalities compared with complete CV screening needed evaluation.
Do questionnaire-based pre-participation screening algorithms accurately detect medical and cardiovascular abnormalities compared to a complete medical evaluation in male subjects?
Do questionnaire-based pre-participation screening algorithms accurately detect medical and cardiovascular abnormalities compared to a complete medical evaluation in male subjects?
Questionnaire-based pre-participation screening algorithms miss approximately one-quarter of medical and cardiovascular abnormalities compared to a comprehensive medical evaluation.
Questionnaire-based PPSAs miss ~24% of abnormalities on full evaluation; leaves open whether enhanced screening improves sports eligibility decisions.
BACKGROUND: Several pre-participation screening algorithms (PPSAs) have been proposed to assess sports eligibility in different populations. They are usually based on self-administered questionnaires, without further medical assessment if no risk factors are documented. The Med-Ex "Formula Benessere" worksite program includes a complete cardiovascular (CV) screening for all participants. The purpose of this study was to assess PPSAs accuracy in detecting medical and/or CV abnormalities in the general population, comparing the results with the date derived from Med-Ex program. METHODS: The Med-Ex medical evaluation, consisting of medical history, physical examination (including body composition), resting electrocardiogram (ECG) and exercise stress test in 464 male subjects (38.4 aged) was analyzed and matched to several PPSAs - Physical Activity Readiness Questionnaire (PAR-Q) (2002-2020), American Heart Association (AHA)/American College of Sport Medicine (ACSM) (1998-2009-2014-2015), European Association of Cardiovascular Prevention and Rehabilitation (EACPR) (2011) - retrospectively simulated. RESULTS: Five-hundred and 67 abnormalities were detected though Med-Ex medical evaluation, and one-fourth (24%) would have been undetected applying PPSA alone. In particular 28% of high blood pressure, 21% of impaired fasting glycaemia, 21% of high Body Mass Index (BMI) values and 19% of ECG abnormalities would have been missed, on average, by all PPSAs. CONCLUSIONS: The simulation analysis model performed in this study allowed to highlight the limits of PPSAs in granting sport eligibility, compared to a medical-guided CV screening. These findings emphasize the importance of a more balanced approach to pre-participation screening that includes a thorough evaluation of the cost/benefit ratio.
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Palermi et al. (2022) studied this question.
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