gaaboard.com

QuoteThe GAA has decided against introducing mandatory screening of inter-county players, despite the fact that some may be at risk to sudden cardiac death.

Instead, the special committee set up to decide on the matter will recommend to the Management Committee that testing 600 players – a cross-section of county senior and minor hurlers and footballers – is a better starting point. Screening is mandatory in both the FAI and IRFU and several county boards have privately screened their county teams.

The decision has been met with disappointment by those who have campaigning heavily for blanket screening of all inter-county squads since the tragic death of Tyrone captain Cormac McAnallen in March 2004.

McAnallen's family has lobbied passionately since his death for regularized screening and has suggested that a mobile screening unit could help solve any logistical problems. The national Sudden Cardiac Death Taskforce has recommended that all senior inter-county players should be screened for Sudden Adult Death Syndrome (SADS).

Sourced HoganStand.com: http://www.hoganstand.com/ArticleForm.aspx?ID=69144

Out of curiousity, who voted no and why?

Here's a good article on this issue:
http://www.uchc.edu/ocomm/features/stories/stories06/feature_italianstudycardiacdeaths.html

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Upside:
"In 1982, Italy implemented a program to try and reduce SCDs by performing screening on all 12- to 35-year-olds who planned to participate in any strenuous competitive sport......
Initially young athletes were five times more likely to suffer from SCD than nonathletes. Now they are half as likely, suggesting that the program may benefit all young people"

Downside:
There is also concern about young athletes that will not be able to participate because of false findings.  "How many athletes were prevented from competitive athletics by the screening?" ...... "Who didn't need to be excluded and thus had an unnecessary lifestyle change?"
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Seems like the upside agrument wins for me.

GAA to begin small-scale screening - Setanta.com

A GAA sub-committee has decided to begin a small-scale screening programme to test for Sudden Adult Death Syndrome (SADS) amongst small cross-section of intercounty players.

Campaigners for mass mandatory screening will be disappointed that the GAA's Medical, Scientific and Welfare Committee has advised the Association's Management Committee to begin testing on a small scale. GAA chiefs will be advised to screen 600 hurlers and footballers across Senior and Minor level.

Both the FAI and IRFU screen their elite players and now the GAA will put in place precautions to alert doctors to those who might be susceptible to SADS.

The National Sudden Cardiac Death Taskforce believes that all senior intercounty players should be screened; however, there are two sides to this debate within international medicine.

Essentially, one side believes that screening should be mandatory across all elite sports people as saving even one life would be worth it, while the other camp says that one per cent of athletes will be told to give up their sport despite no guarantees that they will ever suffer from SADS.

A number of county boards, such as Kilkenny, have already screened their intercounty panels.

However, it is estimated that mandatory screening within the GAA arena would result in around 20 senior intercounty players being told to hang up their boots.

- told to hang up boots. Who like?

I can see the agrument against forcing people out of the game. But I don't see any argument about providing free screening, so people can at least know if there's a risk and decide for themselves.

I'm surprised there's so many voting against!

There are certain criteria's set down for screening programmes, the link below will give you a better understanding..

http://www.gp-training.net/training/audit/screen.htm

You see Ziggylo, when you do a bit of research the knee-jerk re-action isn't alway the right one. In fact it rarely is. Posters on here aren't stupid. That's why so many voted no.

Quote from: Flat Hedgehog on November 17, 2006, 04:58:07 PM
You see Ziggylo, when you do a bit of research the knee-jerk re-action isn't alway the right one. In fact it rarely is. Posters on here aren't stupid. That's why so many voted no.

You see Hedgehog, I didn't make any sort of judgement. I wanted this to also be a discussion, rather than just a voting thread.

Don't you you see me!! :'(

Are you heading down on Sunday? Good luck!

I think the word "mandatory" is a bit misleading here. Whatever happens, I don't think that the GAA is going to be 'forcing' people to get screened. As "the gael" has pointed out so eloquently, Gaelic games are something players choose to play. No-one is depending on Gaelic games for a livelihood.

So people should put it in context - if 20 players out of 2000 were to have to consider giving up their amateur game, isn't that better than one of them dropping dead on Croke Park some day? And if, God forbid, that ever happens, imagine what the reaction would be. The country would beat lumps out of the GAA over it, saying they can't say they weren't warned and couldn't they have spent some of their millions to stop it happening.

So at least every inter-county senior team, considering the amount of pressure they put their bodies through, should be screened, with individuals having the right to opt out.

If the national Taskforce on Sudden Death recommended screening for all inter-county players, aren't they the experts, and shouldn't their word be crucial here?

I

Quote from: Flat Hedgehog on November 17, 2006, 05:09:32 PM
Are you heading down on Sunday? Good luck!

I hope too. I'm dosed with the cold today and feeling pretty shitty. Plus I've an assignment to hand in on Monday. All being well, I'll be there.

my friend died at 22 and a screening would havegiven him a better chance, i cannot see how anyone could be against it.not full proof.

Difficult subject to address. While the screening program in Italy shows some good results, it is somewhat limited. The authors themselves admit that the scheme only picks up certain cardiac abnormalities (from memory, i think it is good at identifying structural problems with the heart such as cardiomyopathy) but it is poor at picking up rhythm disturbances (such as long QT syndrome) and other causes of sudden cardiac death. The issue is further complicated by the fact that these conditions are not fully understood. We don't know why some people who come through the screening with an 'all clear' get SAD and why some of those who have problems identified on screening never suffer any ill effects.

I'm really not sure what the answer to all this is. More needs to be done, but i'm not sure what exactly.

Good post Down22, you're well read about the subject and the shortcomings of screening for some people, but I think you've already answered the riddle you pose.

The only way we are going to get more information on these conditions is by doing more screening. Otherwise we keep our heads in the sand and just watch young people die suddenly forever more. We don't say, cancer is a difficult condition, so we shouldn't really do anything - that's why we spend millions on researching for a cure for it. Ditto AIDS, SARS, Bird Flu, meningitis.

The facts are that the Italians, by doing lots of screening, are cutting the number of deaths. Few medical procedures are ever simple or perfect, but we must follow best practice.

Like PhP, I lost a good friend to one of these heart defects and I am amazed that people can say, "it's too difficult, let's not bother".

I think one of the main problems with this whole issue is the lack of knowledge. These cardiac conditions are very rare and this makes properly controlled research (such as randomised control trials) impossible. The treatment for many of these rare cardiac conditions is usually based on small, non-randomised trials. However, due to the rare nature of these conditions there never will be proper randomised control trials (they would also be unethical). So important decisions are made on the limited evidence available.

The study cited in the article is based on a population study carried out in one region of Italy. It's been a while since I read the full artice (will look it out) but from what I remember it does show promising results.(however, it is subject to the bias associated with a population study).

And I agree with you when you say something needs to be done. I like the idea of a screening program, but it's a huge huge undertaking. There are many areas to be considered

-  What age do you start screening at?
-  The numbers of players involved (how many kids play GAA?) Where are we going to do the ECG? How many ECGs are we going to perform? Who's going to read the ECG (this is one area where you do need a specialist).
-  If someone tests 'positive' then you need to screen all first degree relatives
-  Genetic testing needs to be considered for all first degree relatives
-  Counselling needs to be arranged- a 'postive' test represents a huge life change (it's not as simple as giving up sport). There will be frequent doctors appointments, many more tests, drugs to be taken, possiblity of operations, even lifestyle changes such as having no alarm clocks and turning down the doorbell. There is a risk for the mother in future pregnancies. It's a huge life changing diagnosis.

So, who pays for all this? (I've no idea how the scheme in Italy was funded and who covered the medical costs of the patients)Will costs for treatment be covered? (some of the treatments at present for these conditions are experimental). Who will run the screening program? You'll need an experienced team in this field (not easy to find) and someone who can read an ECG properly (very very hard to find).

None of the above points are a good reason for not doing it. As you rightly say - just because it's difficult, does not mean that it isn't worth doing.

However, I don't think the resources are there for a nationwide GAA screening scheme yet. It would take a few years to get a scheme running and unforunately money will be a problem. The scheme will only pick up structural problems in the heart and not any of the other causes. But if we're serious about doing something we need to start somewhere.