{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T03:53:59Z","timestamp":1773374039894,"version":"3.50.1"},"reference-count":66,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2026,2,19]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the outcomes of pre-participation cardiovascular screening among National Collegiate Athletic Association (NCAA) athletes and quantify the added value of history and physical exam (H&amp;P) when combined with a screening ECG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>MEDLINE (1946\u2013present), EMBASE (1947\u2013present), PubMed (1966\u2013present) and Cochrane Library (1991\u2013present).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria for selecting studies<\/jats:title>\n                    <jats:p>Peer-reviewed research articles published in English reporting original findings on pre-participation cardiovascular screening outcomes in NCAA athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>18 studies, representing 27 891 NCAA athletes (44.2% female), were included. A total of 66 (0.24%) athletes were diagnosed with a cardiovascular condition associated with serious morbidity or sudden cardiac arrest\/death (SCA\/D). Wolff-Parkinson-White was the most common diagnosis (n=39, 59.1%), followed by hypertrophic cardiomyopathy (n=11, 16.7%). Among the eight studies (16\u2009609 athletes) for which the screening performance of ECG and H&amp;P could be extracted separately, ECG screening resulted in a 3.5-fold higher detection rate of true positive cases (number needed to screen (NNS) =475) compared with H&amp;P alone (NNS=1661). The false positive rate for H&amp;P was 17% versus 5% for ECG (p&lt;0.001). The added value of H&amp;P in athletes with a negative ECG was low (NNS=3003).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ECG screening significantly increases the detection of conditions associated with serious morbidity or SCA\/D compared with H&amp;P alone, with H&amp;P providing minimal added value in athletes with a normal ECG. Our findings support the utility of ECG in preparticipation screening for NCAA athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42020188308.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-110791","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T18:20:21Z","timestamp":1772562021000},"page":"379-387","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-participation cardiovascular screening among NCAA athletes: a systematic review and meta-analysis of 27 891 athletes"],"prefix":"10.1136","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1942-1342","authenticated-orcid":false,"given":"Justin J","family":"Conway","sequence":"first","affiliation":[{"name":"Division of Sports Medicine, Crystal Run Healthcare, Newburgh, New York, USA"},{"name":"Optum Center for Research and Innovation, Minnetonka, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5501-8812","authenticated-orcid":false,"given":"Dylan","family":"Bennett","sequence":"additional","affiliation":[{"name":"Primary Sports Medicine Service, HSS, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0655-6264","authenticated-orcid":false,"given":"Irfan M","family":"Asif","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7829-0595","authenticated-orcid":false,"given":"Masaru","family":"Teramoto","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3857-2779","authenticated-orcid":false,"given":"Brett G","family":"Toresdahl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"2026031210502087000_60.5.379.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.01.041"},{"key":"2026031210502087000_60.5.379.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.065908"},{"key":"2026031210502087000_60.5.379.3","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1056\/NEJMra2312555","article-title":"Sudden Cardiac Arrest in Athletes","volume":"394","author":"Lampert","year":"2026","journal-title":"N Engl J Med"},{"key":"2026031210502087000_60.5.379.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102666"},{"key":"2026031210502087000_60.5.379.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2007.039420"},{"key":"2026031210502087000_60.5.379.6","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093840"},{"key":"2026031210502087000_60.5.379.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097331"},{"key":"2026031210502087000_60.5.379.8","doi-asserted-by":"publisher","DOI":"10.1080\/14779072.2020.1787154"},{"key":"2026031210502087000_60.5.379.9","article-title":"Correction to: Clinical Considerations for Competitive Sports Participation for Athletes With Cardiovascular Abnormalities: A Scientific Statement From the American Heart Association and American College of Cardiology","volume":"151","author":"Kim","year":"2025","journal-title":"Circulation"},{"key":"2026031210502087000_60.5.379.10","unstructured":"Pre-participation cardiovascular screening of young competitive athletes: policy guidance. 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