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Web-based multimedia athlete preparticipation questionnaire: introducing the video-PPE (v-PPE)
  1. Gary Parizher1,
  2. John D Putzke2,3,
  3. Rachel Lampert4,
  4. Michael Scott Emery5,
  5. Aaron Baggish6,
  6. Matthew Martinez7,
  7. Ariel Levine8,
  8. Benjamin D Levine9,10
  1. 1 Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  2. 2 Department of Psychiatry and Behavioral Sciences, Mercer University School of Medicine, Macon, Georgia, USA
  3. 3 Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
  4. 4 Department of Medicine, Division of Cardiology, Yale University School of Medicine, New Haven, Connecticut, USA
  5. 5 Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
  6. 6 Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
  7. 7 Division of Cardiology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
  8. 8 International Creative Management, Los Angeles, California, USA
  9. 9 Institute for Exercise and Environmental Medicine, Dallas, Texas, USA
  10. 10 University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
  1. Correspondence to Dr Benjamin D Levine, Institute for Exercise and Environmental Medicine, Dallas, TX 75231, USA; benjaminlevine{at}

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Preparticipation evaluation (PPE) to screen athletes for signs and symptoms of heart disease is recommended by the American Heart Association (AHA), American Academy of Pediatrics (AAP), American Association of Family Physicians and multiple sports organisations.1 The 14-point questionnaire and the fourth edition of the Pre-participation Evaluation Monograph are two recommended screening tools. PPE is standard-of-care for high school and college athletes. As specific symptoms precede sudden cardiac death in adolescents in up to 20%–45% of cases, accurate screening can be life-saving.2 3 In contrast to asymptomatic individuals, symptomatic patients have the most compelling indications for additional testing and possible intervention, with the greatest benefit:risk ratio. However, many screening instruments do not adhere to current guidelines.4 Furthermore, nuanced symptoms are addressed with blunt questions that are easy to misinterpret, and no research has been done to improve participants’ understanding of survey items. The current PPE is hampered by a high false-positive response rate that is challenging for clinicians caring for adolescent athletes.5

We developed a video-assisted online preparticipation survey. Computerised questionnaires may be more accurate than paper surveys, especially given adolescents’ comfort with online technology and the highly saturated mobile device markets.6 We included …

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  • Correction notice This article has been corrected since it published Online First. The second version of this article includes a copy edited version.

  • Contributors All authors made substantial contributions to the design of the work and were responsible for drafting, critically revising and approving the final version of the manuscript. The first author wrote the manuscript and all other authors contributed to critical revisions. All authors contributed to the content of the video elements described in the manuscript. All authors agree to be accountable for all aspects of the work and ensuring that questions related to the accuracy and integrity of any part of the work are investigated and resolved.

  • Funding Funders were The Texas chapter of the American College of Cardiology, and the Fikes Foundation.

  • Disclaimer The sponsors had no role in designing the study or in the preparation, review or approval of the manuscript. ScienceTRAX had no role in funding the study or in the preparation, review or approval of the manuscript.

  • Competing interests JDP is president of ScienceTRAX, LLC.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.