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Screening Electrocardiogram in Young Athletes and Military Members: A Systematic Review and Meta-Analysis

Journal of athletic training, 2022-05, Vol.57 (5), p.444-451 [Peer Reviewed Journal]

by the National Athletic Trainers' Association, Inc. ;Copyright National Athletic Trainers Association May 2021 ;Copyright National Athletic Trainers Association May 2022 ;by the National Athletic Trainers' Association, Inc 2022 2022 ;ISSN: 1062-6050 ;EISSN: 1938-162X ;DOI: 10.4085/1062-6050-0746.20 ;PMID: 34038955

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  • Title:
    Screening Electrocardiogram in Young Athletes and Military Members: A Systematic Review and Meta-Analysis
  • Author: Lear, Aaron ; Patel, Niraj ; Mullen, Chanda ; Simonson, Marian ; Leone, Vince ; Koshiaris, Constantinos ; Nunan, David
  • Subjects: Athletes ; Bias ; Cardiac stress tests ; Cardiology ; Cardiovascular disease ; Coronary vessels ; Death, Sudden, Cardiac - prevention & control ; Electrocardiography ; Humans ; Mass Screening ; Meta-analysis ; Military Personnel ; Systematic review ; Vein & artery diseases
  • Is Part Of: Journal of athletic training, 2022-05, Vol.57 (5), p.444-451
  • Description: To determine the effect of electrocardiogram (ECG) screening on the prevention of sudden cardiac arrest and death in young athletes and military members. MEDLINE, Embase, CENTRAL, Web of Science, BIOSIS, Scopus, SPORTDiscus, PEDro, and ClinicalTrials.gov were searched from inception to dates between February 21 and July 29, 2019. Randomized and nonrandomized controlled trials in which preparticipation examination including ECG was the primary intervention used to screen athletes or military members aged ≤40 years. Acceptable control groups were those receiving no screening, usual care, or preparticipation examination without ECG. Three published studies and 1 conference abstract were identified for inclusion. In all 4 studies, risk of bias was assessed using the Cochrane risk-of-bias tool and was found to be generally high. Two studies had data extracted for random effects meta-analysis, and the remaining study and conference abstract were included in the narrative review. The overall quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. We included 4 nonrandomized studies (11 689 172 participants), of which all had a high risk of bias. Pooled data from 2 studies (n = 3 869 274; very low-quality evidence) showed an inconclusive 42% relative decrease in risk of sudden cardiac death (relative risk = 0.58; 95% CI = 0.23, 1.45), equating to an absolute risk reduction of 0.0016%. The findings were consistent with a potential 77% relative decreased risk to a 45% relative increased risk in participants screened using ECG. Heterogeneity was found to be high, as measured using I2 statistic (71%). Data from the remaining study and abstract were similarly inconclusive. Existing evidence for the effect of ECG screening is inconclusive and of very low quality. In our meta-analysis, we observed that screening ECG may result in a considerable benefit or harm to participants. Higher-quality studies are needed to reduce this uncertainty.
  • Publisher: United States: National Athletic Trainers Association
  • Language: English
  • Identifier: ISSN: 1062-6050
    EISSN: 1938-162X
    DOI: 10.4085/1062-6050-0746.20
    PMID: 34038955
  • Source: ProQuest One Psychology
    Geneva Foundation Free Medical Journals at publisher websites
    MEDLINE
    PubMed Central
    Alma/SFX Local Collection
    Free E Journals
    ProQuest Central
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