Advancing the preparticipation physical evaluation (PPE): An ACSM and FIMS joint consensus statement

Abstract

While the preparticipation physical evaluation (PPE) iswidely accepted, its usage and content are not standardized. Implementation is affected by cost, access, level of participation, participant age/sex, and local/regional/ national mandate. PPE screening costs are generally borne by the athlete, family, or club. Screening involves generally agreed-upon questions based on expert opinion and tested over decades of use. No large-scale prospective controlled tracking programs have examined PPE outcomes. While the panel did not reach consensus on electrocardiogram screening as a routine part of PPE, all agreed that a history and physical examfocusing on cardiac risk is essential, and an ECGshould be usedwhere risk is increased. Themany areas of consensus should help the American College of SportsMedicine and the Fédération Internationale duMédicine du Sport in developing a universally accepted PPE. An electronic PPE, using human-centered design, would be comprehensive, would provide a database given that PPE is mandatory in many locations, would simplify PPE administration, would allow remote access to clinical data, andwould provide themuch-needed data for prospective studies in this area.