"Shared Decision-Making" in Athletes With Known Cardiac Disease: Interpretation and Implementation in the Real World.

OBJECTIVE Recommendations for addressing sporting eligibility and disqualification in athletes with heart disease have traditionally used a paternalistic approach with cardiologists making a binary yes-no decision. This paradigm has recently evolved to a model recognizing and respecting the autonomy of the athlete while instituting safeguards to mitigate risk where possible. How well this paradigm is understood or has been integrated into the athletic trainer (AT) community is unknown. DESIGN Athletic trainers from the Ohio High School Athletic Association were surveyed. RESULTS Of 107 ATs who responded, we found that the majority had not heard of the term shared decision-making in the context of sporting participation [62.6%, confidence interval (CI) 0.53-0.72 vs 37.4%, CI 0.28-0.47]. Furthermore, we found large discrepancies as to how ATs would interpret and implement recommendations from cardiologists. CONCLUSIONS This study highlights the need to educate and improve communication between AT, sports medicine physicians, and sports cardiologists if strategies are to become widely implemented.