Key result
Division I institutions were significantly more likely to add an ECG and/or echocardiogram (30%) to their preparticipation examination compared with lower divisions (P < 0.0001).
Cross-Sectional (n=224)
Yes
p-value: p=<0.0001
A significant portion of Division I collegiate programs use noninvasive cardiac screening (ECG/echocardiogram) for athletes, highlighting variation from traditional history and physical examination screening methods.
Screening varies by division level; leaves open whether adding ECG/echo improves outcomes or warrants standardized protocols.
OBJECTIVE: Determine the cardiovascular screening practices of college team physicians. DESIGN: Cross-sectional survey. SETTING: Electronic mail with a link to a 9-item survey. PARTICIPANTS: American Medical Society for Sports Medicine college team physicians. INTERVENTIONS: Screening practices survey administered to college team physicians. MAIN OUTCOME MEASURES: Cardiovascular preparticipation screening practices including noninvasive cardiac screening (NICS) such as electrocardiogram (ECG) or echocardiogram. RESULTS: Two hundred twenty-four of 613 AMSSM members identifying themselves as college team physicians (36.5%) responded: National Collegiate Athletic Association Division I: 146, Division II: 41, Division III: 27, National Association of Intercollegiate Athletics: 8, and Junior College: 2. The majority (78%) of schools conducted the American Heart Association (AHA) 12-element history and physical examination. Division I institutions were more likely to add an ECG and/or echocardiogram (30%) to their preparticipation examination (PPE) compared with lower divisions (P < 0.0001). Those Division I schools using NICS were more likely to do so for all athletes (P < 0.001) or revenue generating sports (P < 0.001), whereas other institutions did so only for high-risk subgroups (P < 0.01). Lower division schools would consider adding ECG if it cost less (P = 0.01) or if there were more local expertise in athlete-specific interpretation standards (P = 0.04). CONCLUSIONS: Many National Collegiate Athletic Association Athletes Division I programs already use NICS to screen athletes, whereas a significant portion of lower division schools add ECG for athletes deemed high risk. Increased use of these modalities suggests limitations of traditional PPE screening methods. CLINICAL RELEVANCE: This is the first study to assess cardiac screening practices across all collegiate divisions and broadens our understanding of cardiac screening in high-level athletes.
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Asplund et al. (2014) conducted a cross-sectional in Cardiovascular preparticipation screening practices (n=224). Cardiovascular preparticipation screening practices vs. Lower division institutions was evaluated on Cardiovascular preparticipation screening practices including noninvasive cardiac screening (NICS) such as electrocardiogram (ECG) or echocardiogram (p=<0.0001). Division I institutions were significantly more likely to add an ECG and/or echocardiogram (30%) to their preparticipation examination compared with lower divisions (P < 0.0001).
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