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June 10, 1998

Preparticipation Screening of Athletes

Author Affiliations

From the Division of Sports Medicine, Department of Functional Restoration, Stanford University School of Medicine, Stanford, Calif.

JAMA. 1998;279(22):1829-1830. doi:10.1001/jama.279.22.1829

In this issue of JAMA, the article by Glover and Maron1 addresses the issue of improving the sensitivity of the preparticipation examination (PPE) to detect silent, clinically important cardiovascular abnormalities that place the athlete at risk for sudden cardiac death (SCD). Fortunately, SCD is rare in high school athletes. But the appeal of being able to identify risk factors and thereby prevent SCD, coupled with the legal obligation for sports organizations and institutions to provide a safe environment for athletes points to the need to consider, wherever possible, ways to improve the sensitivity of the PPE. Glover and Maron have identified the following problems with the high school PPE process: (1) 16% of states have no approved history and physical examination forms; (2) of the 84% of states that do, questions deemed essential for detecting abnormalities were missing from half of the history forms and more than 60% of the physical examination forms; and (3) only 40% of the states had questionnaires that incorporated the majority of 1996 American Heart Association recommendations.

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