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Preparticipation Cardiovascular Screening for Young Athletes—Reply

Barry J. Maron, MD; Glen C. Pfister, BS; James C. Puffer, MD
JAMA. 2000;284(8):957-958. doi:10.1001/jama.284.8.956.
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In Reply: We agree with Drs Carek and Mainous that the PPE, as performed at many institutions, may not adequately assess risk for all of the causes of morbidity and mortality in the athlete population. However, the specific objective of our study was to evaluate the utility of screening questionnaires in detecting cardiovascular disease in athletes, using the 1996 AHA guidelines1 as a criterion. While the 1996 USPSTF Guide to Clinical Preventive Services is extensive, we found it devoid of information or guidelines directed specifically toward the detection, in young athletic populations, of those particular cardiovascular abnormalities known to be responsible for sudden cardiac death on the athletic field,2 such as hypertrophic cardiomyopathy2,3 and therefore does not appear to qualify as a criterion standard for medical screening in all areas, as Carek and Mainous propose. Indeed, this was precisely our purpose in designing the AHA guidelines for young athletes, which we believe are superior and the most appropriate available criteria for our critique of preparticipation cardiovascular screening.


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