Defence - Preventive medicine: Periodic health evaluation in elite sports

Information

Date

January 27

Location

NIH - digital/streaming

Time

14:30

Content

Preventive medicine reduces the impact of health problems by stopping them from occurring and reducing their burden.

SEE Nabhan's defence live

In elite sport, one aspect of preventive medicine is the periodic health evaluation (PHE). The objectives of the PHE are to comprehensively review of an athlete’s health status, assess for risk of future health problems, serve as an entry point into the healthcare system, and to monitor health over time. Several approaches to the PHE have been described, with varying levels of clinician-patient engagement, necessary resources, and clinical complexity.

Dustin Nabhan is a research fellow at the Department of Sports Medicine at NIH. He currently leads the medicine and science departments at Canyon Ranch in Arizona, USA.
On January 27, 2022, he will defend his dissertation:
"Preventive medicine in elite sport: the role of the periodic health evaluation"

Despite widespread adoption, whether PHEs improve the health and wellness of athletes is unknown. Better understanding of the PHE can result in improved health for athletes, more efficient resource allocation for sport organizations, and will guide other areas of athlete health promotion research and practice.

The aim of this dissertation is to describe current PHE practices in elite athlete populations and assess the value of specific elements of the PHE: the health history, iron screening, and screening for conditions that are difficult to diagnose in primary care (sleep, mental health, and allergies).

Key findings

The PHE at top performing NOCs is a comprehensive process that involves collaboration of multiple experts across sports medicine and science. The practices of NOCs are heterogenous. Programs are often customized for specific athlete populations and emphasize the importance of identifying existing conditions so they can be managed with athlete-specific action plans. Current practices suggest that the PHE has evolved beyond health evaluations and medical risk screenings, and include tests used to guide individual injury prevention programs and profile the performance of athletes in the event of future injury.
Patient interviews capture four times as many past or current injuries than electronic questionnaires in athletes training for the Olympic and Paralympic Games. Biases associated with patient self-reporting of health information make health history data collection difficult in this patient population.
The inclusion of standardized screening tools in an electronic health history resulted in the identification of potential mental health, sleep, and allergy problems in both Olympic and Paralympic athletes. Strong associations between anxiety, depression and sleep disorders highlight the importance of comprehensive screening programs to identify risk factors for these conditions.
SF data from the largest elite athlete cohort to appear in the literature indicates that the SF distribution is different between elite athletes and normal men. While there was no difference in the SF distribution between elite athlete and normal women, a substantial portion of both groups can be considered iron deficient. Routine iron screening is strongly recommended in both the male and female athlete populations.

READ disseretation: "Preventive medicine in elite sport: the role of the periodic health evaluation"

SEE Nabhan's defence live

Comitee

Associate professor Jostein Steene-Johannessen, Department of Sports Medicine, NIH (chair)
Professor Tim Meyer, Institute of Sports and Preventive Medicine, Saarland University (1st opponent)
Associate Professor Babette Marie Pluim, Academic Centre for Evidence based Sports medicine (ACES), Amsterdam; Collaboration for Health and Safety in Sports (ACHSS); AMC/VUmc IOC Research Center (2nd opponent)