Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
In Reply: Drs Gunn and Friedman
raise the issue of incorporating selected biomedical screening tests
into the PPE, specifically testing for C trachomatis genital
tract infections. What they are suggesting is expanding the acquisition
of information from the history and physical examination to include
laboratory testing for preventable, treatable premorbid conditions.
Their suggestion raises several points for discussion.
What are appropriate limits for a PPE? While these are quite easy to
define in relation to readiness for participation in sport, what
determines the cut point for inclusion of tests unrelated to sport
participation but important for disease treatment and prevention? Is
the mandate for the PPE to improve health, to determine readiness for
sport, or both? Why stop at testing for Chlamydia? What about
testing for cholesterol levels in large football linemen or
asymptomatic iron deficiency in runners or spondylolysis in gymnasts
and divers? Are the appropriate limits of a PPE set by risk ratios and
Matheson GO. Cardiovascular Screening of High School Athletes—Reply. JAMA. 1999;281(7):607–608. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-7-jbk0217
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