Sudden deaths of young athletes fuel the heart screening debate

by Olga Deshchenko, DOTmed News Reporter | June 28, 2011
From the June 2011 issue of HealthCare Business News magazine

To counter some of the potential false positives, Berman’s screening program performs a “quick look echocardiogram” test on students whose ECGs look suspicious. Since starting the program in 2007, Beaumont has screened more than 5,500 kids.

On top of the false positive and false negative rates of ECGs, cost is a common argument against the test. The screening program at Beaumont is funded through philanthropy, with physicians volunteering their time. “If people actually had to pay for this, it would be expensive,” says Berman.

Exactly how expensive?
In a recent study, researchers in Texas screened 2,506 students from 70 school districts using two different models. In one model, students got an ECG exam, and if the test results looked suspicious for hypertrophic cardiomyopathy, athletes also got an echocardiogram. In the other model, all students got both an ECG and an echo exam.

“Because it was a research study, a lot of the costs were involved in doing the research,” says Dr. William Scott, chief of cardiology at Children's Medical Center and professor of pediatrics at the University of Texas Southwestern Medical Center, who took part in the study. “When we tried to break it down into what it costs to do the study, it came out to what we thought was fairly reasonable.”

Scott and colleagues found that an ECG and a screening echo cost about $60 per student. The cost per student when an echo was only done if a student had a suspicious ECG was around $42.

Scott points out that the goal of this particular study was to find out whether or not it was feasible to offer the same quality cardiac screening for student athletes throughout the state, regardless of location. “There’s no question that you can find [heart abnormalities],” he says. “Whether or not this is the best way to do it, we don’t know.”

Yet, Scott points out that nothing in the research data contradicts the current screening recommendations maintained by medical societies.

The researchers plan to publish the complete results of their study in a cardiology journal soon.

In defense of ECGs
Supporters of ECG screenings for athletes say opposition to the test because of its false positive rate is flawed.

Dr. Joseph Marek, a cardiologist who leads the Midwest Heart Foundation, an Illinois-based nonprofit dedicated to improving cardiovascular health through research and community initiatives, knows a thing or two about the test.

As the founder and medical director of the foundation’s Young Hearts for Life (YH4L) Cardiac Screening Program, Marek and his team have screened more than 60,000 active students using ECGs.

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