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Athletes’ view on screening: more appreciation than scepticism

Comment by Hein Heidbuchel, EACPR Sports Cardiology Section

Cardiovascular pre-participation screening does not distress professional football players
EE Solberg, TH Bjørnstad, TE Andersen, Ø Ekeberg
European Journal of Cardiovascular Prevention & Rehabilitation published online 25 May 2011, DOI: 10.1177/1741826711410818

Cardiovascular pre-participation screening of athletes has been debated among physicians and authorities, and various countries have decided whether or not and to which extent screening should be conducted. Athletes’ own view on screening, however, is unknown, perhaps surprisingly because patient autonomy in other areas of medicine is strongly emphasised.

A recently published survey of 441 Norwegian male elite soccer players, conducted in Oslo under the lead of Dr. Erik Solberg, showed 88% were satisfied completing the screening and that they felt safer when they played. Only 16% were afraid that the screening results could have implications for their own health, and 13% were concerned that screening could lead to losing their player license. This concern should be taken seriously in screening settings, and stresses the importance for standardised evaluation and management of relevant findings to reassure the athletic community. Less than 3% were clinically distressed by the screening, as measured by the validated Impact of Event Scale. Since the study was anonymous, with players only identifiable by their team, it was not possible to evaluate whether a prior positive cardiac screening predicted answers to the survey. Given the small numbers of relevant findings with impact on sports participation, if any, this limitation would not have major impact on the overall findings.

The study is the first to show unequivocally that the players were positive to screening and would recommend it to other players. Screening did not constitute significant distress to these athletes and the distress argument should no longer be held against screening.