ECG Improves Sensitivity of Young Athlete Screening
More cardiac problems found, but false-positives increase too; still, practice may be cost-effective
TUESDAY, March 2 (HealthDay News) -- Adding 12-lead electrocardiography (ECG) to preparticipation cardiovascular screening for college athletes improves overall sensitivity to detection of cardiac abnormalities and may be cost-effective, but it also increases the number of false-positive results, according to two studies published in the March 2 Annals of Internal Medicine.
Aaron L. Baggish, M.D., of Massachusetts General Hospital in Boston, and colleagues conducted a study of 510 college athletes who underwent regular screening comprising medical history and physical examination followed by ECG to detect cardiac abnormalities, and found that sensitivity was 45.5 percent without ECG and 90.9 percent with ECG. However, the specificity was 94.4 without ECG and 82.7 percent with it, and including ECG was associated with a false-positive rate of 16.9 percent (versus 5.5 percent).
Matthew T. Wheeler, M.D., of the Stanford University School of Medicine in California, and colleagues used existing data on screening for athletes aged 14 to 22 years and found that adding ECG to screening saves 2.06 lives per 1,000 athletes, adds an incremental cost of $89 per athlete, and yields a cost-effectiveness ratio of $42,900 per life-year saved when compared with a cardiovascular-focused history and physical exam alone. Compared with no screening, ECG plus physical exam and cardiovascular-focused history saves 2.6 life-years per 1,000 athletes, costs $199 per athlete, and yields a cost-effectiveness ratio of $76,100 per life-year saved.
"In conclusion, we show that preparticipation screening of young athletes with ECG plus cardiovascular-focused history and physical examination is reasonable in cost and effective at saving lives," Wheeler and colleagues write.