The preparticipation physical evaluation: an analysis of clinical practice.
OBJECTIVE
To evaluate current preparticipation physical evaluation (PPE) clinical practice behaviors.


METHODS
Telephone and Web-based survey study with attention to utilization of the Fourth Edition PPE Monograph.


METHODS
We contacted the Washington State American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) chapters, all Washington State high school athletic directors (ADs), and every state high school athletic association.


METHODS
Data collection and analysis regarding clinical practice.


METHODS
Awareness and utilization of the Fourth Edition PPE Monograph.


RESULTS
The response rate was 72% (559/776) from the AAP, 56% (554/990) from the AAFP, 75% (317/424) from the ADs, and 100% (50/50) from the state athletic associations. Few physicians (37%) and ADs (6%) reported an awareness of the PPE Monograph. Knowledge of the Monograph did not vary by physician type, practice/school location, or experience (P > 0.05). Reported obstacles to the delivery of the PPE included time with patient (56%) and the lack of a standard form (52%). Physician awareness of the Monograph reduced the perception of obstacles (P < 0.01). Athletic directors reported financial limitations of the family as the primary obstacle (62%). Adoption of a single statewide PPE form was well supported (96% of physicians and 67% of ADs). Nationally, only 46% of state athletic associations mandate a single form, and only 16% use a form consistent with the Fourth Edition PPE Monograph.


CONCLUSIONS
The medical community is largely unaware of national screening guidelines. New directions for education and policy are necessary to improve this implementation gap.
*Division of Pediatric Cardiology, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio; †Section of Sports Medicine, Department of Family Medicine, University of Washington, Seattle, Washington; and ‡Division of Pediatric Cardiology, Department of Pediatrics, University of Washington, Seattle, Washington.
Nicolas L
NL
Madsen
Jonathan A
JA
Drezner
Jack C
JC
Salerno
D001291:Attitude of Health Personnel; D005194:Family Practice / Q000592:standards*; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008487:Medical History Taking / Q000592:standards; D010372:Pediatrics / Q000592:standards*; D010808:Physical Examination / Q000191:economics / Q000592:standards*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011996:Records; D012574:Schools / Q000458:organization & administration / Q000592:standards*; D013177:Sports; D014861:Washington