The Need for a Reliable Score to Guide ED Management

  • Thiruganasambandamoorthy V, et al. ED management of syncope: need for standardization and improved risk stratification. Intern Emerg Med. 2015;10:619-627. pdf

  • Baugh CW, Sun BC. Variation in diagnostic testing for older patients with syncope in the ED. Am J Emerg Med. 2019;37:810-816. pdf

Recent Reviews of Available ED Syncope Risk-stratifying Tools

  • Sweanor RA, et al. Multivariable risk scores for predicting short term outcomes for ED patients with unexplained syncope: a systematic review. Acad Emerg Med. 2021;28(5):502-510. pdf

  • Tannenbaum L, et al. Can I send this syncope patient home from the ED? J Emerg Med. 2021;61(6):801-809. pdf

Original Derivation and Validation Studies of the Canadian Syncope Risk Score

  • Thiruganasambandamoorthy V, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after ED assessment of syncope. CMAJ. 2016;188:E289-e298. pdf

  • Thiruganasambandamoorthy V, et al. Multicenter ED validation of the Canadian Syncope Risk Score. JAMA Intern Med. 2020;180:737-744. pdf

  • Thiruganasambandamoorthy V, et al. Personalised risk prediction following ED assessment for syncope. Emerg Med J. 2021 Nov 5 [Online ahead of print]. pdf

Attempted Validation Outside Canada

  • Solbiati M, et al. Multicentre external validation of the Canadian Syncope Risk Score to predict adverse events and comparison with clinical judgement. Emerg Med J. 2021;38(9):701-706. pdf

This small Italian study went back into a prospective dataset that did not actually include all the Canadian Risk Score variables. They substituted what they had for the missing subjective variables. These methodological handicaps prevent the study from being a true test of the Canadian score.

Can Machine Learning Algorithms Improve the Canadian Score?

  • Grant L, et al. Machine learning versus traditional methods for the development of risk stratification scores: a case study using original Canadian Syncope Risk Score data. Intern Emerg Med. 2021 Nov 3. Online ahead of print. pdf