Policy on cardiac screening criticised

NEWS:THE GAA'S cardiac screening programme has been criticised by Bridget McAnallen, mother of Cormac, who died suddenly four years ago, and founder and trustee of the Cormac Trust, which campaigns on the issue of sudden cardiac death among young people.

She was responding to an interview in this newspaper with Dr Pat Duggan, chair of the GAA's Medical, Scientific and Welfare Committee, who outlined the association policy on screening through the universal use of questionnaires with referral procedures for those who fill in positives.

"I'm not saying questionnaires are a bad idea, but on their own they're not as effective as full screening," Bridget McAnallen said. "We would call on the GAA to give everyone an ECG (electro-cardiogram), and if a problem shows up that person can be referred. The ECG is a very simple and quickly done procedure, and although any abnormality needs to be read by a specialist, the initial monitoring can be by someone who can spot an abnormality.

"A proposal was out to the GAA that a mobile ECG unit could travel around clubs and monitor all children about to take up hurling or football at the age of 10 or 11. Some specialists say that certain conditions only show up at a later stage, but children as young as 10 do die of sudden cardiac death."

Funding for the proposal was estimated at €1,250,000, but it was also suggested public funding could be secured as well as sponsorship, plus individual contributions from the families involved.

According to Dr Duggan, the medical community is divided on the most effective form of screening. The one chosen by the GAA is common in the US, whereas that proposed by the Cormac Trust is the model adopted in Italy. Bridget McAnallen points out that the experience in Italy has led to an 89 per cent reduction in sudden cardiac deaths among young people.

Questionnaires, she argues, are only as good as the information provided and family histories will not always be readily apparent to those completing the forms.

The trust also takes issue with Dr Duggan's estimate of the number of young people dying from sudden cardiac death at between one in 200,000 and 300,000, pointing out that other statistics suggest a figure closer to between 50,000 and 100,000 and even anecdotal evidence points to a considerably higher incidence.

Those supporting the GAA's position on this cite the unsustainable costs involved in universal screening, as well as the likelihood of "false positives", which can worry people into giving up sport.

According to Bridget McAnallen, as this is a matter of life and death it should be for the individual to decide what way they would respond to their specific tests. She doesn't believe the costs involved are prohibitive and questions the priorities with the health system.

"I can't really say what motivates doctors and health professionals at the present time. There are certain conditions on which they're prepared to spend a huge amount of money, but there other things they seem to neglect for whatever reason.

"Some health professionals have said it comes down to money and they're afraid of the numbers they may have to screen. But we're talking about screening between the ages of 10 and 14.

"I don't know what the statistics are for road deaths, but if it was thought that 100 people could be saved by doing certain things they would be doing them.

"There are all sorts of treatments that cost a lot of money for all types of conditions and would come to a lot more than the cost of screening young people."