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Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 1:00pm
by TonyR
Ayesha wrote:Should there be 'qualifiers' for large over-subscibed Sportive and charity rides?
Like letters of reference from Club secretaries, or a recent Audax medal?

How do the organisers know the entry is capable of finishing? Or do they care?


This is a much bigger issue than this event. Twelve young people die suddenly each week through cardiac problems that can be easily diagnosed. Before our kids took up sport seriously we had them CRY screened and got the all clear but you have to pay for it. There should be much better availability of screening for all school kids - its as easy as having an ECG taken.

For the event itself its very difficult for the organisers to do anything other than offer advice and the risk is very low - about a 1 in 80,000 probability

Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 1:22pm
by [XAP]Bob
If it's ECG levels of simplicity then it would only take a day or so to do a whole school year at most schools - well worth it.

From: https://www.whatdotheyknow.com/request/ ... _in_uk_200

It appears that there are about 800k children of any given age (assume low mortality and balanced migration).
We'd therefore be screening 800k people, assuming we pick up 12 that's a terribly low percentage.
What's the false positive rate? False negative?

Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 1:47pm
by Audax67
TonyR wrote:Twelve young people die suddenly each week through cardiac problems that can be easily diagnosed.


They can be easily diagnosed, yes - once you think to look. An ECG at our GP's place costs around 75€, enough to put off most casual demands (OK, you get it back from the Social Security, but still). And someone who's felt healthy all his life would hardly think of asking.

In 2007 I did a 1000k Audax with a climb up the Tourmalet followed by PBP, and a month later did my best ever time up the Ventoux. In November I had a stress test that picked up a constricted artery, later fixed with a stent. I had been planning to do LEL in 2008: the cardiologist cheerily informed me that undiagnosed I'd probably have died doing it. Last year the doc who looks after my gammy ankles keeled over with cardiac arrest at a family gathering: if his wife hadn't been an anaesthetist and known what do he'd have been out of it. He was a veteran 100 cols rider whose idea of a holiday was to ride the Pyrenees one end to the other.

Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 8:14pm
by timdownieuk
I'm sorry but although the benefits of screening seem irrefutable, ECG screening has a lot of problems. The fact that there is no national ECG screening system in place isn't an error of omission but actually a considered decision. Have a read of this.

http://www.drjohnm.org/2012/05/the-ny-t ... -athletes/

It's from across the pond but the arguments work here too.

Tim

Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 8:40pm
by TonyR
timdownieuk wrote:I'm sorry but although the benefits of screening seem irrefutable, ECG screening has a lot of problems. The fact that there is no national ECG screening system in place isn't an error of omission but actually a considered decision. Have a read of this.

http://www.drjohnm.org/2012/05/the-ny-t ... -athletes/

It's from across the pond but the arguments work here too.

Tim


Do they? In Italy they introduced mandatory cardiac screening for all young people engaging in organised sport and saw an 89% drop in sudden cardiac deaths in that group compared to no change in the non-screened non-athlete control group.

http://jama.jamanetwork.com/article.asp ... eid=203513

Here you can get CRY screening for free and the screening is carried out by experienced doctors with a specific interest in young sudden cardiac death. The main argument of your link seems to be that the doctors doing the screening won't be expert enough to detect what they need to.

Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 9:38pm
by Audax67
Trouble is that a lot of defects will only show up under stress. You can take a quick ECG with an iPhone and adapter but a true stress test needs heavy equipment and takes around 20 minutes. Still, you could pick up a good few on a resting ECG.

Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 9:50pm
by kwackers
Audax67 wrote:Trouble is that a lot of defects will only show up under stress. You can take a quick ECG with an iPhone and adapter but a true stress test needs heavy equipment and takes around 20 minutes. Still, you could pick up a good few on a resting ECG.

I wonder just how good an ECG is at spotting stuff.

Someone mentioned arrhythmia further up. IME the problem is that to figure out what's wrong you need an episode to occur whilst plugged into the ECG.
I get occasional bouts of arrhythmia but I've never had one whilst wearing an ECG and so the problem (if it is one) continues undiagnosed.

Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 9:56pm
by TonyR
Audax67 wrote:Trouble is that a lot of defects will only show up under stress. You can take a quick ECG with an iPhone and adapter but a true stress test needs heavy equipment and takes around 20 minutes. Still, you could pick up a good few on a resting ECG.


Well in that case a number of expert doctors are wasting their time and the Italian results have been falsified. But I'm sure a bunch of cyclists know better.

Re: Cyclist dies on Surrey 100

Posted: 13 Aug 2014, 10:02pm
by kwackers
TonyR wrote:Well in that case a number of expert doctors are wasting their time and the Italian results have been falsified. But I'm sure a bunch of cyclists know better.

Actually - have you looked at those figures?

1.9 deaths per 100,000.

By the end of the study they were disqualifying over 2% of the people from their sports!

That's 2,000 people not allowed to participate to save 1 life...
I wonder how many of those will die later from obesity - given they've probably got the mindset of "best not exert myself, I've got a weak heart"...

Re: Cyclist dies on Surrey 100

Posted: 14 Aug 2014, 10:09am
by [XAP]Bob
So the false positive rate was high - that was the question I asked up thread.

With a very low incidence you end up damaging more people by testing than by not testing.
http://www.bbc.co.uk/news/magazine-28166019

Re: Cyclist dies on Surrey 100

Posted: 14 Aug 2014, 7:18pm
by iviehoff
Colin_P wrote:It took 45 minutes so I believe for an actual ambulance to get to him.

They should arrive at suspected heart attacks much quicker than that. Though it is possible that the mere fact of the cycling event made it difficult for them to get there.

But it is far from unusual for them to take much longer than they should, even in light traffic conditions, as I had the chance to experience myself recently, when I had a muscle spasm in my chest that did a very good imitation of a heart attack.

Re: Cyclist dies on Surrey 100

Posted: 14 Aug 2014, 9:43pm
by TonyR
iviehoff wrote:
Colin_P wrote:It took 45 minutes so I believe for an actual ambulance to get to him.

They should arrive at suspected heart attacks much quicker than that. Though it is possible that the mere fact of the cycling event made it difficult for them to get there.


They should but then it was exception weather conditions with flooded roads and heavy wind and rain on top of all the road closures to deal with. So hardly normal circumstances.

Re: Cyclist dies on Surrey 100

Posted: 15 Aug 2014, 8:59pm
by TonyR
Memorial ride on Sunday at Newlands Corner.
http://road.cc/content/news/126700-cycl ... ridelondon

Re: Cyclist dies on Surrey 100

Posted: 16 Aug 2014, 12:37pm
by Stewart H
I am not sure an ECG will show up all potential problems, I had an ECG about fourteen hours before my heart attack two years ago, it showed nothing.

Re: Cyclist dies on Surrey 100

Posted: 19 Aug 2014, 6:57pm
by mr_pedalling
Condolences to family and friends RIP