Roberts William O, Asplund Chad A, O'Connor Francis G, Stovitz Steven D
University of Minnesota, 1414 Maryland Avenue East, St Paul, MN.
Georgia Regents University, 300 E Hospital Rd, Augusta, GA.
J Electrocardiol. 2015 May-Jun;48(3):311-5. doi: 10.1016/j.jelectrocard.2015.01.010. Epub 2015 Jan 28.
The addition of an electrocardiogram (ECG) to the current United States athlete preparticipation physical evaluation (PPE) as a screening tool has dominated the PPE discussion over the past decade despite the lack of demonstrable outcomes data supporting the routine use of the diagnostic study for reduction of sudden cardiac death (SCD). A good screening test should influence a disease or health outcome that has a significant impact on public health and the population screened must have a high prevalence of the disease to justify the screening intervention. While SCD is publicly remarkable and like any death, tragic, the prevalence of SCD in young athletes is very low and the potential for false positive results is high. While ECG screening appears to have made an impact on SCD in Italian athletes, the strategy has made no impact on Israeli athletes, and the overall impact of ECG screening on American athletes is unclear. Until outcomes studies show substantial SCD reduction benefit, the addition of routine ECG PPE screening in young athletes should not be instituted.
在过去十年中，尽管缺乏可证明的结果数据支持将心电图（ECG）作为筛查工具常规用于美国运动员赛前体格检查（PPE）以降低心源性猝死（SCD），但将其纳入当前的美国运动员赛前体格检查一直主导着PPE的讨论。一个好的筛查测试应该能影响对公众健康有重大影响的疾病或健康结果，并且接受筛查的人群中该疾病的患病率必须很高，才有理由进行筛查干预。虽然心源性猝死备受公众关注，而且像任何死亡一样令人悲痛，但年轻运动员中心源性猝死的患病率非常低，假阳性结果的可能性很高。虽然心电图筛查似乎对意大利运动员的心源性猝死产生了影响，但该策略对以色列运动员没有影响，而且心电图筛查对美国运动员的总体影响尚不清楚。在结果研究表明能大幅降低心源性猝死风险之前，不应在年轻运动员中开展常规心电图PPE筛查。
