Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Scand J Med Sci Sports. 2023 Nov;33(11):2360-2368. doi: 10.1111/sms.14462. Epub 2023 Aug 3.
To determine if two pre-race screening tools (abbreviated tool of two open-ended pre-race medical screening questions [ABBR] vs. a full pre-race medical screening tool [FULL]) identify running race entrants at higher risk for medical encounters (MEs) on race day.
5771 consenting race entrants completed both an ABBR and a FULL pre-race screening questionnaire for the 2018 Comrades Marathon (90 km). ABBR tool questions were (1) allergies, and (2) known medical conditions and/or prescription medication use. The FULL tool included multiple domains of questions for chronic diseases including cardiovascular disease (CVD), symptoms, risk factors, allergies and medication use. ABBR responses were manually coded and compared to the FULL tool. The prevalence (%: 95%CI), and the test for equality of prevalence of entrants identified by the ABBR vs. FULL tool is reported.
The ABBR identified fewer entrants with allergies (ABBR = 7.9%; FULL = 10.4%: p = 0.0001) and medical conditions/medication use (ABBR = 8.9%; FULL = 27.4%: p = 0.0001). The ABBR tool significantly under-reported entrants with history of cardiovascular disease (CVD), CVD risk factors, other chronic diseases and prescription medication vs. the FULL tool (p = 0.0001). The ABBR tool identified fewer entrants in the "high" (ABBR = 3.4%; FULL = 12.4%) and "very high" risk (ABBR = 0.5%; FULL = 3.4%) categories for race day MEs (p = 0.0001).
An abbreviated pre-race screening tool significantly under-estimates chronic medical conditions, allergies, and race entrants at higher risk for MEs on race day, compared with a full comprehensive screening tool. We recommend that a full pre-race medical screening tool be used to identify race entrants at risk for MEs.
确定两种赛前筛查工具(简化的两个开放式赛前医学筛查问题工具[ABBR]与完整的赛前医学筛查工具[FULL])是否能识别出参赛跑步者在比赛日发生医疗事件(MEs)的风险更高。
2018 年 Comrades 马拉松(90 公里)比赛中,5771 名同意参加的参赛者完成了 ABBR 和 FULL 赛前筛查问卷。ABBR 工具的问题是(1)过敏,和(2)已知的医疗状况和/或处方药使用情况。FULL 工具包括心血管疾病(CVD)、症状、危险因素、过敏和药物使用等多个慢性病领域的问题。ABBR 的回答是手动编码的,并与 FULL 工具进行比较。报告了 ABBR 与 FULL 工具识别的参赛者的患病率(%:95%CI),以及患病率相等的检验结果。
ABBR 识别出的过敏(ABBR=7.9%;FULL=10.4%:p=0.0001)和医疗状况/药物使用(ABBR=8.9%;FULL=27.4%:p=0.0001)人数较少。ABBR 工具显著低估了有心血管疾病(CVD)病史、CVD 危险因素、其他慢性病和处方药使用的参赛者比例,而 FULL 工具则没有(p=0.0001)。ABBR 工具识别出的“高”(ABBR=3.4%;FULL=12.4%)和“非常高”(ABBR=0.5%;FULL=3.4%)风险类别中发生比赛日 MEs 的参赛者人数较少(p=0.0001)。
与完整的综合筛查工具相比,简化的赛前筛查工具显著低估了慢性疾病、过敏和比赛日 MEs 风险较高的参赛者。我们建议使用完整的赛前医学筛查工具来识别有发生 MEs 风险的参赛者。