Outcomes in syncope research: it is time to standardize

• Published in: Internal and emergency medicine Vol. 13; no. 4; pp. 589 - 591
• Main Authors: Ruwald, Martin Huth, Olshansky, Brian
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2018; Springer Nature B.V
• Subjects: CE - Commentary; Clinical outcomes; Hospitalization; Internal Medicine; Medical research; Medicine; Medicine & Public Health; Syncope
• ISSN: 1828-0447; 1970-9366
• DOI: 10.1007/s11739-018-1841-y

Syncope, a common condition causing sudden and transient loss of consciousness with rapid and complete recovery, remains a huge management problem for the clinician and a potentially debilitating one for the patient. Derived from the Greek word synkoptein (“to cut short”), syncope, first described by Hippocrates, continues to confound us. It presently accounts for 1–2% of emergency department (ED) visits, and, due to concerns of recurrence and associated adverse consequences including death, leads commonly to hospital admission, at which time, extensive, unproductive, costly, and non-diagnostic evaluations are the rule. The reasoning for the hospitalization decisions remains obscure, and no real, cogent, or rational outcome measure is generally considered. Benefits from hospitalization are difficult to quantitate. Despite the immensity of the problem, syncope evaluation and subsequent data collection for patient care and research purposes is time-consuming and tedious. Furthermore, recurrences and their severity are unpredictable. Thus, quality and outcome measures have not been collected systematically and researched scrupulously nor quantitated carefully. Based on the totality of the data, guideline documents have developed risk assessment and diagnostic pathways, but outcome measures remain obscure.