Cardiovascular screening practices in collegiate student-athletes.

OBJECTIVE: To evaluate screening practices and preparticipation evaluation (PPE) forms used to identify, or raise suspicion of, cardiovascular abnormalities in collegiate student-athletes. DESIGN: Phone and e-mail survey. SETTING: National Collegiate Athletic Association (NCAA) Division I universities. PARTICIPANTS: All 347 NCAA Division I universities were invited to participate in 2010-2011; 257 universities (74%) elected to participate. MAIN OUTCOME MEASURES: Information about the preparticipation screening process was obtained from team physicians and/or certified athletic trainers. PPE forms were evaluated for the inclusion of the 12 specific American Heart Association (AHA) recommendations for cardiovascular screening of competitive athletes from the 2007 AHA Council on Nutrition, Physical Activity, and Metabolism consensus panel endorsed by the American College of Cardiology Foundation. RESULTS: All 257 participating universities (100%) required preparticipation screening for freshman and transfer athletes, and 83 universities (32%) required an annual PPE for returning athletes. The PPE was performed on campus at 85% of the universities, whereas 15% of universities allowed the PPE to be completed by the athlete's choice of physician before he or she arrived on campus. Eleven universities (4%) used the recently updated American College of Sports Medicine 4th edition PPE. Sixteen universities (6%) used the American College of Sports Medicine 3rd edition PPE. The remaining 260 universities (90%) did not use either of these forms. Of the 257 Division I universities, only 21 universities (8%) met the AHA recommendations by including all 12 cardiovascular screening items on their PPE forms. CONCLUSION: The majority (92%) of NCAA Division I universities do not use PPE forms that meet the AHA recommendations for cardiovascular screening; therefore, they may not be effectively screening collegiate student-athletes for cardiovascular abnormalities that could lead to sudden cardiac death.

Female athlete triad screening in National Collegiate Athletic Association Division I athletes: is the preparticipation evaluation form effective?

OBJECTIVE: To evaluate the screening practices and preparticipation evaluation (PPE) forms used to identify college athletes at risk for the female athlete triad (triad). DESIGN: Phone and/or e-mail survey. SETTING: National Collegiate Athletic Association (NCAA) Division I universities. PARTICIPANTS: All 347 NCAA Division I universities were invited to participate in a survey, with 257 participating in the survey (74%) and 287 forms collected (83%). MAIN OUTCOME MEASURES: Information about the nature of the PPE was requested from team physicians and certified athletic trainers during a phone or e-mail survey. In addition, a copy of their PPE form was requested to evaluate for inclusion of the 12 items recommended by the Female Athlete Triad Coalition for primary screening for the triad. RESULTS: All 257 universities (100%) required a PPE for incoming athletes; however, only 83 universities (32%) required an annual PPE for returning athletes. Screening was performed on campus at 218 universities (85%). Eleven universities (4%) were using the recently updated fourth edition PPE. Only 25 universities (9%) had 9 or more of the 12 recommended items included in their forms, whereas 127 universities (44%) included 4 or less items. Relevant items that were omitted from more than 40% of forms included losing weight to meet the image requirements of a sport; using vomiting, diuretics, and/or laxatives to lose weight; and the number of menses experienced in the past 12 months. CONCLUSIONS: The current PPE forms used by NCAA Division I universities may not effectively screen for the triad.