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Cost-Effectiveness of Different Types of Evaluations Before Sports Participation in Young Athletes FREE

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The summary below is from the full report titled “Cost-Effectiveness of Preparticipation Screening for Prevention of Sudden Cardiac Death in Young Athletes.” It is in the 2 March 2010 issue of Annals of Internal Medicine (volume 152, pages 276-286). The authors are M.T Wheeler, P.A. Heidenreich, V.F. Froelicher, M.A. Hlatky, and E.A. Ashley.

Ann Intern Med. 2010;152(5):I-40. doi:10.7326/0003-4819-152-5-201003020-00002
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What is the problem and what is known about it so far?

In the United States, sudden death in young people participating in competitive sports occurs at a low rate. Previously unknown heart disease is the leading cause of these deaths. Major medical organizations recommend that young athletes be evaluated for heart disease before they participate in organized sports. However, recommendations about how to evaluate young athletes vary. The American College of Cardiology and the American Heart Association recommend a medical history and physical examination, with further testing if history or examination is abnormal. The European Society of Cardiology and the International Olympic Committee recommend including electrocardiography (ECG); this test records the electrical impulses in the heart and provides information about abnormal heart rhythms and other heart conditions.

Why did the researchers do this particular study?

To find out how much it would cost per year of life gained to add ECG to medical history and physical examination for young athletes.

Who was studied?

The researchers did not study real patients. Instead, they developed a computer simulation that estimated what would happen to competitive athletes aged 14 to 22 years if they were evaluated before sports participation with medical history and physical examination alone or with ECG.

How was the study done?

The researchers based the computer model on estimates from previous studies of how many cases of heart disease would be found with history and physical examination alone and with ECG and how many cases of sudden death might be prevented by keeping athletes with heart conditions from playing sports. They also looked at the costs of testing and for caring for heart disease to calculate how much adding ECG would cost per year of life gained.

What did the researchers find?

Compared with screening with history and physical examination alone, adding ECG costs about an additional $42 900 per year of life saved. This is within the range that U.S. society is typically willing to pay for health care interventions.

What were the limitations of the study?

Computer simulations cannot definitively show what would happen in the real world. Much of the information that went into the model comes from 1 European study, but types of heart disease vary by geography.

What are the implications of the study?

Adding ECG to history and physical examination of young athletes would be within the range that U.S. society is typically willing to pay for health care tests or treatments.





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