Mike Ray, MD from CrossFit Flagstaff, is a presenter at various CrossFit Level 1 seminars. He’s also an ER doc. This lecture on pre-participation screening is from the Science of Exercise seminar on April 26th, 2009 in Fort Worth, TX. The video is from CrossFit Again Faster.
Pre-participation screening of athletes is an honorable venture. The sudden death of an athlete is a tragedy in every sense of the term. The attempt to avoid or eliminate tragedy by pre-screening those athletes susceptible to it is natural and fully understandable.
Dr. Ray looks at some of the statistics associated with screening and sudden death. The conclusions are dramatic, and put the practice of pre-screening in a different light.
According to one source, 1 in 200,000 athletes under 35 years old are at significant risk of dying during athletic activity. If we were to develop a pre-screening test that was 99% accurate (though in reality, we don’t have anything nearly that good), 99.95% of all the positive test results would be false positives (the explanation of this is in part 2).
The first of two primary conclusions of Dr. Ray’s lecture is that as much as we would like to prevent tragedy, the statistical reality is that we don’t have a reasonable means of doing so with pre-participation screening.
The second primary conclusion is that as tragic as sudden death is, these tests are significantly more likely to stop safe athletes from healthy activity than they are to prevent unsafe athletes from harm. This is unfortunate and preventable with clear thinking.
Part 1 is the technical background to the lecture. 18min 1sec
Part 2 is the conclusion, from which the essence of the entire lecture could be garnered if time were a consideration. 10min 44sec