The Israel screening failure analyzing the data to understand the results.

The Italian experience showed a significant decrease in mortality over the entire time period after the implementation of the screening program (p for trend <0.001), through analysis of the time trend of death rates with Poisson regression of the number of SCDs in each year against the calendar year, including the log of the amount of person-time at risk in each year as an offset term. Poisson regression analysis of the mortality trend over 26 years allowed the potential limitation of a relatively short pre-screening period to be overcome. Indeed, the comparison of the SCD trend between screened athletes and unscreened nonathletes (i.e., a control population of the same age from the same geographic area) during the same study period provided compelling evidence of the selective decrease in mortality in young athletes undergoing screening. Although the authors' aim to explain the trend of SCDs in Israel athletes is laudable, their conclusion that the mortality rate in young athletes cannot be changed by implementing pre-participation screening is not supported by scientifically reliable data.