The role of ECG screening in the evaluation of risk of sudden cardiac arrest in the young.

We have the opportunity to answer the questions that have been raised and obtain answers by prospective evaluation. ECG screening does not need an all-or-none approach in the current era. It needs a commitment to obtain the relevant data that will be accepted as applicable in the United States. Multiple populations, genders, ages, ethnicities, and races should be screened in a prospective ECG screening study. The actual costs should be obtained and cost utility analysis should be performed. Models of screening should be developed and tested. It is no longer acceptable to say "It can't be done here"; or "It costs too much"; or any of the scores of excuses used unless one can support the statements with trials or scientific data. A study of 100,000 children ages 5-19 years would cost $500,000-750,000. Is it not worth finding out who is correct, how to better identify those at risk, and how to do it in the most cost-efficient manner? No one wants to waste $2 billion a year. However, a one-time investment of 25% of that amount would determine how best to use our health care resources in the future to identify children and youth at risk for SCA.