ArticleBMC emergency medicine2020
Diagnostic accuracy of evaluation of suspected syncope in the emergency department: usual practice vs. ESC guidelines.
Article in BMC emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05555771 (Determining the Effectiveness of Counterpressure Maneuvers in Pediatric Patients Presenting With Syncope to the Emergency Department), which is not on this map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Determining the Effectiveness of Counterpressure Maneuvers in Pediatric Patients Presenting With Syncope to the Emergency Department
Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Syncope diagnostic evaluation in a southern European population: patterns of clinical practice and cost implications.BMC health services research · 2026Observational
- Design and rationale of the RISC-trial: multicentreEuropean heart journal open · 2026Article
- Now is the time to take syncope seriously.The British journal of cardiology · 2026Article
- A Quality Improvement Project to Improve Syncope Care Through Structured Triage and Risk Stratification (STARS).Cureus · 2025Article
- Comparison of autonomic nervous system dysfunction, arterial stiffness, and heart rate recovery according to spinal cord injury level.The Journal of international medical research · 2024Article
- Recent Advances and Future Directions in Syncope Management: A Comprehensive Narrative Review.Journal of clinical medicine · 2024Review
- A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Co-designing and piloting educational materials with patients and healthcare providers for syncope in the emergency department.PEC innovation · 2023Article
- Diagnostic and societal impact of implementing the syncope guidelines of the European Society of Cardiology (SYNERGY study).BMC medicine · 2023Article
- Article
- Syncope Diagnosis at Referral to a Tertiary Syncope Unit: An in-Depth Analysis of the FAST II.Journal of clinical medicine · 2023Article
- Pediatric syncope: pearls and pitfalls in history taking.Clinical and experimental pediatrics · 2023Article
- Trauma and syncope: looking beyond the injury.Trauma surgery & acute care open · 2023Review
- Recent Updates and Technological Developments in Evaluating Cardiac Syncope in the Emergency Department.Current cardiology reviews · 2022Article
- Planning Implementation Success of Syncope Clinical Practice Guidelines in the Emergency Department Using CFIR Framework.Medicina (Kaunas, Lithuania) · 2021Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSyncope is a frequent reason for referral to the emergency department. After excluding a potentially life-threatening condition, the second objective is to find the cause of syncope. The objective of this study was to assess the diagnostic accuracy of the treating physician in usual practice and to compare this to the diagnostic accuracy of a standardised evaluation, consisting of thorough history taking and physical examination by a research physician.
methodsThis prospective cohort study included suspected (pre) syncope patients without an identified serious underlying condition who were assessed in the emergency department. Patients were initially seen by the initial treating physician and the usual evaluation was performed. A research physician, blinded to the findings of the initial treating physician, then performed a standardised evaluation according to the ESC syncope guidelines. Diagnostic accuracy (proportion of correct diagnoses) was determined by expert consensus after long-term follow-up.
resultsOne hundred and one suspected (pre) syncope patients were included (mean age 59 ± 20 years). The usual practice of the initial treating physicians did not in most cases follow ESC syncope guidelines, with orthostatic blood pressure measurements made in only 40% of the patients. Diagnostic accuracy by the initial treating physicians was 65% (95% CI 56-74%), while standardised evaluation resulted in a diagnostic accuracy of 80% (95% CI 71-87%; p = 0.009). No life-threatening causes were missed.
conclusionsUsual practice of the initial treating physician resulted in a diagnostic accuracy of 65%, while standardised practice, with an emphasis on thorough history taking, increased diagnostic accuracy to 80%. Results suggest that the availability of additional resources does not result in a higher diagnostic accuracy than standardised evaluation, and that history taking is the most important diagnostic test in suspected syncope patients. Netherlands Trial Registration: NTR5651. Registered 29 January 2016, https://www.trialregister.nl/trial/5532.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.