Med-Ex, Medicine & Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy.
Department of Public Health, University of Naples Federico II, Naples, Italy.
J Basic Clin Physiol Pharmacol. 2022 Jun 1;33(5):655-663. doi: 10.1515/jbcpp-2022-0109. eCollection 2022 Sep 1.
Several pre-participation screening algorithms (PPSAs) have been proposed to assess sports eligibility in different populations. They are usually based on self-administered questionnaires, without further medical assessment if no risk factors are documented. The Med-Ex "Formula Benessere" worksite program includes a complete cardiovascular (CV) screening for all participants. The purpose of this study was to assess PPSAs accuracy in detecting medical and/or CV abnormalities in the general population, comparing the results with the date derived from Med-Ex program.
The Med-Ex medical evaluation, consisting of medical history, physical examination (including body composition), resting electrocardiogram (ECG) and exercise stress test in 464 male subjects (38.4 aged) was analyzed and matched to several PPSAs - Physical Activity Readiness Questionnaire (PAR-Q) (2002-2020), American Heart Association (AHA)/American College of Sport Medicine (ACSM) (1998-2009-2014-2015), European Association of Cardiovascular Prevention and Rehabilitation (EACPR) (2011) - retrospectively simulated.
Five-hundred and 67 abnormalities were detected though Med-Ex medical evaluation, and one-fourth (24%) would have been undetected applying PPSA alone. In particular 28% of high blood pressure, 21% of impaired fasting glycaemia, 21% of high Body Mass Index (BMI) values and 19% of ECG abnormalities would have been missed, on average, by all PPSAs.
The simulation analysis model performed in this study allowed to highlight the limits of PPSAs in granting sport eligibility, compared to a medical-guided CV screening. These findings emphasize the importance of a more balanced approach to pre-participation screening that includes a thorough evaluation of the cost/benefit ratio.
已有多种用于评估不同人群运动适宜性的预参赛筛选算法（PPSA）被提出。这些算法通常基于自我报告的问卷，如果没有记录到风险因素，则无需进一步进行医学评估。Med-Ex“Formula Benessere”工作场所计划为所有参与者提供全面的心血管（CV）筛查。本研究的目的是评估 PPSA 在检测一般人群中医疗和/或 CV 异常方面的准确性，将结果与 Med-Ex 计划得出的数据进行比较。
分析了 Med-Ex 医学评估的结果，该评估包括病史、体格检查（包括身体成分）、静息心电图（ECG）和 464 名男性（平均年龄 38.4 岁）的运动应激测试，并与多个 PPSA 进行了匹配：体力活动准备问卷（PAR-Q）（2002-2020 年）、美国心脏协会（AHA）/美国运动医学学院（ACSM）（1998-2009-2014-2015 年）、欧洲心血管预防与康复协会（EACPR）（2011 年）。这些 PPSA 都是回顾性模拟的。
通过 Med-Ex 医学评估共发现了 506 例异常，而仅使用 PPSA 则会漏诊四分之一（24%）的异常。具体来说，平均而言，所有 PPSA 都会漏诊 28%的高血压、21%的空腹血糖受损、21%的高体重指数（BMI）值和 19%的心电图异常。
本研究中进行的模拟分析模型突出了 PPSA 在授予运动适宜性方面的局限性，与医学指导的 CV 筛查相比。这些发现强调了在预参赛筛查中采取更平衡方法的重要性，包括对成本/效益比的全面评估。
