Screening electrocardiogram in young athletes and military members: a systematic review and meta-analysis.
Title
Screening electrocardiogram in young athletes and military members: a systematic review and meta-analysis.
Creator
Lear A; Patel N; Mullen C; Simonson M; Leone V; Koshiaris C; Nunan D
Publisher
Journal Of Athletic Training
Date
2021
2021-05-26
Description
OBJECTIVE: To determine the effect of electrocardiogram (ECG) screening on prevention of sudden cardiac arrest and death (SCA/D) in young athletes and military members. DATA SOURCES: MEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORT discus, PEDro, and clinicaltrials.gov were searched from inception to dates between 2/21/19 and 7/29/19. STUDY SELECTION: Randomized and non-randomized controlled trials, where pre-participation examination including ECG was the primary intervention used to screen athletes or military 40 years of age or younger. Accepted controls were no screening, usual care, or pre-participation examination without ECG. 3 published studies , and one conference abstract were identified for inclusion. DATA EXTRACTION: In all four studies, risk of bias was assessed with the Cochrane risk of bias tool, and 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 narrative review. Overall quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Data Synthesis: Four non-randomized studies (11,689,172 participants) were included, all at high risk of bias. Pooled data from two studies (n= 3,869,274; very low quality evidence) observed an inconclusive 42% relative decrease in risk of sudden cardiac death (RR 0.58; 95% CI 0.23, 1.45), equating to an absolute risk reduction of .0016% The findings were consistent with a potential 67% relative decrease to a 45% relative increased risk in participants screened with ECG. Heterogeneity was found to be high as measured with I2 statistic (71%). Data from the remaining study and abstract were similarly inconclusive. CONCLUSION: Existing evidence for the effect of ECG screening is inconclusive and of very low quality. Our meta-analysis observed that screening ECG may result in considerable benefit or harm to participants. Higher quality studies are needed to reduce this uncertainty. PROSPERO Registration: CRD42019125560.
Subject
sudden cardiac death; athlete; military; sudden cardiac arrest; electrocardiogram screening
Identifier
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Format
journalArticle
URL Address
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ISSN
1938-162X 1062-6050
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Family & Community Medicine
Update Year & Number
June 2021 List
Citation
Lear A; Patel N; Mullen C; Simonson M; Leone V; Koshiaris C; Nunan D, “Screening electrocardiogram in young athletes and military members: a systematic review and meta-analysis.,” NEOMED Bibliography Database, accessed October 11, 2024, https://neomed.omeka.net/items/show/11699.