Correspondence
Utilization and Implementation of Sports Medical Screening Examinations – Survey of More Than 10 000 Long-Distance Runners: In reply
Dtsch Arztebl Int 2008; 105(51-52): 900. DOI: 10.3238/arztebl.2008.0900b
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All screening investigations that our healthcare system offers have to be regarded as a compromise of cost and benefit, on the basis of sufficient evidence. We thank Piper for his additional remarks on diagnostic tests in sports medical screening examinations and the ensuing discussion. Which parts of the examination should be obligatory is the subject of controversial discussions internationally.In the US, routine examinations include merely a medical history and clinical examination; even the resting ECG is controversial. In Europe, qualified ECG diagnostics are the required standard. For further recommendations, especially exercise ergometric tests or cardiac echocardiography, evidence based data are currently lacking. The diagnostic tests recommended by Piper are routinely conducted only in top competitive athletes. This indicates the fundamental problem in screening examinations—namely, who covers the cost? Sports medical screening examinations are not included in the range of services covered by statutory or private health insurers, and patients thus have to pay for themselves (IGeL).The current study shows that especially older leisure time and weekend athletes, as well as those embarking on a sports regime for the first time or re-entering their exercise regime, are at increased risk. Considering the widespread overweight and lack of exercise among Germany's population and the costs incurred as a result of these, we do not understand that such screening examinations are not covered. The authors are of the opinion that it is incumbent on insurers and politicians to act now, so as to give prevention campaigns—often promoted to great effect in the media—a foundation that is sports medically and ethically safe. DOI: 10.3238/arztebl.2008.0900b
Prof. Dr. med. Dr. Sportwiss. Dieter Leyk
Institut für Physiologie und Anatomie
Deutsche Sporthochschule Köln, Carl-Diem-Weg 6
50933 Köln, Germany
Ruether@dshs-koeln.de
Prof. Dr. med. Herbert Löllgen
Präsident der Deutschen Gesellschaft für Sportmedizin und Prävention
Bermesgasse 32b
42897 Remscheid, Germany
h.loellgen@sana-klinikum-remscheid.de
Conflict of interest statement
The authors of both the letter and of the reply declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.
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Gibbons RJ, Balady GJ, Bricker JT: American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee to Update the 1997 Exercise Testing Guidelines. ACC/AHA 2002 guideline update for exercise testing: summary article. J Am Coll Cardiol 2002; 40: 1531–40. MEDLINE
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Löllgen H, Gerke R : Belastungs-EKG (Ergometrie) Herzschrittm Elektrophysiol 2008; 19: 98–106. MEDLINE
| 1. | Drezner JA: Contemporary approaches to the identifiaction of athletes at risk for sudden death. Curr Opin Cardiol 2008; 23: 494–501. MEDLINE |
| 2. | Gibbons RJ, Balady GJ, Bricker JT: American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee to Update the 1997 Exercise Testing Guidelines. ACC/AHA 2002 guideline update for exercise testing: summary article. J Am Coll Cardiol 2002; 40: 1531–40. MEDLINE |
| 3. | Löllgen H, Gerke R : Belastungs-EKG (Ergometrie) Herzschrittm Elektrophysiol 2008; 19: 98–106. MEDLINE |
