ArticleBMC medicine2023
Diagnostic and societal impact of implementing the syncope guidelines of the European Society of Cardiology (SYNERGY study).
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- [Syncope diagnosis in the emergency room-importance of the ESC guidelines].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Utility and best practices for clinical diagnostic testing of the autonomic nervous system: A Consensus Statement Endorsed by the American Autonomic Society and the American Association of Neuromuscular & Electrodiagnostic Medicine.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Review
- Syncope diagnostic evaluation in a southern European population: patterns of clinical practice and cost implications.BMC health services research · 2026Observational
- Setting up an autonomic unit within the neurological department: a position statement of the European Federation of Autonomic Societies.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- 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
- Syncope - mind the gap: it's time to build bridges in the UK.The British journal of cardiology · 2026Article
- Syncope Secondary to Concomitant Ingestion of Tizanidine and Alcohol in a Patient With Alcohol Use Disorder.Cureus · 2024Article
- 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
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18 authors.
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Abstract
backgroundSyncope management is fraught with unnecessary tests and frequent failure to establish a diagnosis. We evaluated the potential of implementing the 2018 European Society of Cardiology (ESC) Syncope Guidelines regarding diagnostic yield, accuracy and costs.
methodsA multicentre pre-post study in five Dutch hospitals comparing two groups of syncope patients visiting the emergency department: one before intervention (usual care; from March 2017 to February 2019) and one afterwards (from October 2017 to September 2019). The intervention consisted of the simultaneous implementation of the ESC Syncope Guidelines with quick referral routes to a syncope unit when indicated. The primary objective was to compare diagnostic accuracy using logistic regression analysis accounting for the study site. Secondary outcome measures included diagnostic yield, syncope-related healthcare and societal costs. One-year follow-up data were used to define a gold standard reference diagnosis by applying ESC criteria or, if not possible, evaluation by an expert committee. We determined the accuracy by comparing the treating physician's diagnosis with the reference diagnosis.
resultsWe included 521 patients (usual care, n = 275; syncope guidelines intervention, n = 246). The syncope guidelines intervention resulted in a higher diagnostic accuracy in the syncope guidelines group than in the usual care group (86% vs.69%; risk ratio 1.15; 95% CI 1.07 to 1.23) and a higher diagnostic yield (89% vs. 76%, 95% CI of the difference 6 to 19%). Syncope-related healthcare costs did not differ between the groups, yet the syncope guideline implementation resulted in lower total syncope-related societal costs compared to usual care (saving €908 per patient; 95% CI €34 to €1782).
conclusionsESC Syncope Guidelines implementation in the emergency department with quick referral routes to a syncope unit improved diagnostic yield and accuracy and lowered societal costs.
trial registrationNetherlands Trial Register, NTR6268.
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