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June 15, 1997Annals of Internal Medicine

CLINICAL GUIDELINE: Diagnosing Syncope: Part 1: Value of History, Physical Examination, and Electrocardiography

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Why the study?

What is the diagnostic yield of various clinical and laboratory tests in the evaluation of patients with syncope?

Population

Patients with syncope or near syncope (based on studies reporting results for at least 10 patients)

Design

Guideline

Authors

MLMark LinzerHennepin Healthcare Research Institute

Discussion

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Overview

Initial syncope evaluation should prioritize history, physical examination, and electrocardiography; reinforces limiting routine neurologic testing absent focal signs.

Structured PICO

What is the diagnostic yield of various clinical and laboratory tests in the evaluation of patients with syncope?

P
Population
Patients with syncope or near syncope (based on studies reporting results for at least 10 patients)
I
Intervention
Diagnostic testing including history, physical examination, electrocardiography, neurologic testing, cardiac testing, tilt testing, and psychiatric evaluation
O
Outcome
Diagnostic yield (number of patients with diagnostically positive test results divided by the number of patients tested, or sum of true-positive and true-negative results divided by number tested for monitoring studies)

Initial evaluation of syncope should focus on a careful history, physical examination, and electrocardiography, which provide a diagnosis or guide further testing in most patients, avoiding low-yield routine neurologic testing.

Limitations

  • Absence of a diagnostic gold standard
  • Paucity of data from randomized trials

Cite This Study

Mark Linzer (1997) studied this question.

synapsesocial.com/papers/6a86bb9e2527c72a71a23910https://doi.org/10.7326/0003-4819-126-12-199706150-00012
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1CLINICAL GUIDELINE: Diagnosing Syncope: Part 2: Unexplained Syncope1997 · 320 citations
  2. 2Syncope: Diagnostic Yield of Various Clinical Investigations2022 · 3 citations
  3. 3Evaluation and Management of the Patient With Syncope1992 · 229 citations
  4. 4Evaluation and management of the patient with syncope1992 · 37 citations
  5. 5Syncope: Current Diagnostic Evaluation and Management1990 · 214 citations