title: Standardised pre-competitive screening of athletes in some European and African countries: the SMILE study.
abstract: Most of the available data on the cardiovascular screening of athletes come from Italy, with fewer records being available outside of Italy and for non-Caucasian populations. The goals of the SMILE project (Sport Medicine Intervention to save Lives through ECG) are to evaluate the usefulness of 12-lead ECGs for the detection of cardiac diseases in athletes from three European countries and one African country and to estimate how many second-level examinations are needed subsequent to the initial screening in order to classify athletes with abnormal characteristics. A digital network consisting of Sport Centres and second and third opinion centres was set up in Greece, Germany, France and Algeria. Standard digital data input was carried out through the application of 12-lead ECGs, Bethesda questionnaires and physical examinations. Two hundred ninety-three of the 6,634 consecutive athletes required further evaluation, mostly (88.4 %) as a consequence of abnormal ECGs. After careful evaluation, 237 were determined to be healthy or apparently healthy, while 56 athletes were found to have cardiac disorders and were thus disqualified from active participation in sports. There was a large difference in the prevalence of diseases detected in Europe as compared with Algeria (0.23 and 4.01 %, respectively). Our data confirmed the noteworthy value of 12-lead resting ECGs as compared with other first-level evaluations, especially in athletes with asymptomatic cardiac diseases. Its value seems to have been even higher in Algeria than in the European countries. The establishment of a digital network of Sport Centres for second/third opinions in conjunction with the use of standard digital data input seems to be a valuable means for increasing the effectiveness of screening.
authors.forename: Deodato
authors.initials: D
authors.lastname: Assanelli
authors.affiliation: Department of Medical and Surgical Sciences, Chair of Sports-Internal Medicine, University of Brescia, 2a Medicina, P.le Spedali Civili 1, 25100, Brescia, Italy, dassanelli@gmail.com.
authors.forename: Assanelli
authors.initials: A
authors.lastname: Deodato
authors.forename: Andrea
authors.initials: A
authors.lastname: Ermolao
authors.forename: Ermolao
authors.initials: E
authors.lastname: Andrea
authors.forename: François
authors.initials: F
authors.lastname: Carre
authors.forename: Carré
authors.initials: C
authors.lastname: François
authors.forename: Asterios
authors.initials: A
authors.lastname: Deligiannis
authors.forename: Deligiannis
authors.initials: D
authors.lastname: Asterios
authors.forename: Klaus
authors.initials: K
authors.lastname: Mellwig
authors.forename: Klaus
authors.initials: K
authors.lastname: Mellwig
authors.forename: Mellwig
authors.initials: M
authors.lastname: Klaus
authors.forename: Mohamed
authors.initials: M
authors.lastname: Tahmi
authors.forename: Tahmi
authors.initials: T
authors.lastname: Mohamed
authors.forename: Bruno Mario
authors.initials: BM
authors.lastname: Cesana
authors.forename: Cesana Bruno
authors.initials: CB
authors.lastname: Mario
authors.forename: Rosella
authors.initials: R
authors.lastname: Levaggi
authors.forename: Levaggi
authors.initials: L
authors.lastname: Rosella
authors.forename: Paola
authors.initials: P
authors.lastname: Aliverti
authors.forename: Aliverti
authors.initials: A
authors.lastname: Paola
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.forename: Sharma
authors.initials: S
authors.lastname: Sanjay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000462:Algeria; D056352:Athletes; D002648:Child; D002675:Child, Preschool; D003935:Diagnostic Techniques, Cardiovascular; D005060:Europe; D006801:Humans; D008875:Middle Aged; D013177:Sports; D055815:Young Adult