In April, the American Heart Association (AHA) released a controversial report recommending that all children with ADD/ADHD have a screening ECG (“EKG”) prior to starting stimulant medication. The American Academy of Pediatrics (AAP) has never recommended screening for all children, and was not made aware of the AHA paper until it was published.
Now the AHA has released a clarification, along with the AAP. The AHA now says that it is reasonable to consider doing an ECG in a child who is going to start stimulant medications. While they say this is a clarification, it is much more, for the original paper clearly states that an ECG should be performed in all patients prior to starting therapy. They now say that it is reasonable but not mandatory. Instead of clarifying, they are backtracking and changing their original recommendation.
Indeed, the AHA has now also released “corrections” to the original article. There are 18 corrections, including one that changes the wording of the ECG recommendation from “we are suggesting that an ECG be added” to “it is reasonable to consider adding an ECG.” This, obviously, is a completely different recommendation.
I have rarely seen such confusing statements and backtracking in medical recommendations, particularly from large, reputable groups like the AHA. The confusion and anxiety caused is most unfortunate.
