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Ghani, S, Papadakis, M, Kemp, S, Zaidi, A, Sheikh, N, Gati, S, Raju, H, Smith, A, Palmer, C, Somauroo, J and Sharma, S (2016) Results of a nationally implemented de novo cardiac screening programme in elite rugby players in England. British Journal of Sports Medicine, 50 (21). ISSN 0306-3674
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Abstract
Background/aim Screening of young competitive athletes remains a contentious issue. In 2010, a nationwide cardiac screening for all elite rugby players was introduced in England. This provided a unique opportunity to prospectively assess the feasibility and cost-effectiveness of a de novo, ECG-based cardiac screening programme.
Methods Between 2010 and 2012, 1191 rugby players aged ≥14 years underwent cardiac screening with a health questionnaire, 12-lead ECG and a consultation with a cardiologist. The players with concerning findings on initial evaluation were offered on-site transthoracic echocardiogram (TTE). Athletes were referred for further investigations as deemed necessary. The overall cost of the screening programme was estimated.
Results After initial evaluation, 9.7% of athletes underwent on-site TTE; 8.2% underwent on-site TTE due to ECG anomalies and 1.4% underwent on-site TTE due to concerns on the questionnaire. After TTE, only 2.9% of the total cohort was referred for further evaluation. Two players were diagnosed with potentially serious conditions; one with Wolff-Parkinson-White, who resumed competition after catheter ablation, and one with hypertrophic cardiomyopathy, who withdrew from competition. During a mean follow-up of 52.8±5.5 months, none of the players who were reassured experienced any adverse cardiac events. The total cost of the screening programme was £59 875, which averaged to a cost of £50 per player or £29 938 per condition identified. Application of refined ECG criteria would reduce the ECG false-positive rate to 4.9%.
Conclusions Preparticipation cardiac screening with 12-lead ECG is feasible. Refinement of the ECG criteria, the use of on-site TTE and expert setting can minimise the burden of unnecessary investigations and reduce costs.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 11 Medical And Health Sciences, 09 Engineering, 13 Education |
| Subjects: | R Medicine > RC Internal medicine > RC1200 Sports Medicine |
| Divisions: | Sport & Exercise Sciences |
| Publisher: | BMJ Publishing Group |
| Related URLs: | |
| Date Deposited: | 09 Apr 2018 11:16 |
| Last Modified: | 04 Sep 2021 10:35 |
| DOI or ID number: | 10.1136/bjsports-2015-095902 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/8430 |
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