Use of diagnostic methods in pre-participation assessment for physical activity in asymptomatic patients. Is it possible to detect cardiovascular disease and prevent sudden death?

We read the article A proposal for preparticipation evaluation and follow up in the prescription of exercise and sports for resistance training by Botia-Osorio et al. 1 in detail and with great interest.We believe some observations should be made regarding the diagnostic methods selected in the preparticipation assessment for physical activity of asymptomatic people to detect cardiovascular disease and prevent sudden cardiac death.In the article, the authors propose different diagnostic methods according to age group and the goals of the activity.However, some of the proposed methods lack scientific evidence for their use in the Colombian context, and the authors leave out certain screening, diagnostic and prognostic principles.The World Health Organization (WHO) published the principles and practices of disease detection through screening programs 2 .This organization recommends using screening tests when the following conditions are met: a) the disease being tested for is common; b) the screening test is valid and reproducible; c) there are resources available for prompt diagnosis and treatment; and d) the cost of detection is balanced with the healthcare cost.Failure to meet any of the criteria would cause more harm than good.