title: Costs and yield of a 15-month preparticipation cardiovascular examination with ECG in 1070 young athletes in Switzerland: implications for routine ECG screening.
abstract: BACKGROUND
  The usefulness and modalities of cardiovascular screening in young athletes remain controversial, particularly concerning the role of 12-lead ECG. One of the reasons refers to the presumed false-positive ECGs requiring additional examinations and higher costs. Our study aimed to assess the total costs and yield of a preparticipation cardiovascular examination with ECG in young athletes in Switzerland.
  
  
  METHODS
  Athletes aged 14-35 years were examined according to the 2005 European Society of Cardiology (ESC) protocol. ECGs were interpreted based on the 2010 ESC-adapted recommendations. The costs of the overall screening programme until diagnosis were calculated according to Swiss medical rates.
  
  
  RESULTS
  A total of 1070 athletes were examined (75% men, 19.7±6.3 years) over a 15-month period. Among them, 67 (6.3%) required further examinations: 14 (1.3%) due to medical history, 15 (1.4%) due to physical examination and 42 (3.9%) because of abnormal ECG findings. A previously unknown cardiac abnormality was established in 11 athletes (1.0%). In four athletes (0.4%), the abnormality may potentially lead to sudden cardiac death and all of them were identified by ECG alone. The cost was 157,464 Swiss francs (CHF) for the overall programme, CHF147 per athlete and CHF14,315  per finding.
  
  
  CONCLUSIONS
  Cardiovascular preparticipation examination in young athletes using modern and athlete-specific criteria for interpreting ECG is feasible in Switzerland at reasonable cost. ECG alone is used to detect all potentially lethal cardiac diseases. The results of our study support the inclusion of ECG in routine preparticipation screening.
authors: Division of Cardiology, Ospedale San Giovanni Bellinzona, Bellinzona, Switzerland.
authors: Andrea
authors: A
authors: Menafoglio
authors: Division of Cardiology, Ospedale San Giovanni Bellinzona, Bellinzona, Switzerland.
authors: Marcello
authors: M
authors: Di Valentino
authors: Division of Cardiology, Ospedale San Giovanni Bellinzona, Bellinzona, Switzerland.
authors: Jeanne-Marie
authors: JM
authors: Segatto
authors: Center for Sports Medicine, Ospedale La Carità Locarno, Locarno, Switzerland.
authors: Patrick
authors: P
authors: Siragusa
authors: Center for Sports Medicine, Ospedale La Carità Locarno, Locarno, Switzerland.
authors: Reto
authors: R
authors: Pezzoli
authors: Center for Sports Medicine, Ospedale La Carità Locarno, Locarno, Switzerland.
authors: Mattia
authors: M
authors: Maggi
authors: Center for Sports Medicine, Ospedale La Carità Locarno, Locarno, Switzerland.
authors: Gian Antonio
authors: GA
authors: Romano
authors: Division of Cardiology, Ospedale Civico Lugano, Lugano, Switzerland.
authors: Giorgio
authors: G
authors: Moschovitis
authors: University Clinic for Cardiology Inselspital Bern, Bern, Switzerland.
authors: Matthias
authors: M
authors: Wilhelm
authors: Division of Cardiology, Ospedale San Giovanni Bellinzona, Bellinzona, Switzerland.
authors: Augusto
authors: A
authors: Gallino
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D003365:Costs and Cost Analysis; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D042241:Early Diagnosis; D004562:Electrocardiography / Q000191:economics; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000191:economics; D006801:Humans; D033162:Incidental Findings; D008297:Male; D010808:Physical Examination / Q000191:economics; D011446:Prospective Studies; D013178:Sports Medicine / Q000191:economics; D013557:Switzerland; D055815:Young Adult
keywords: Cardiology prevention