Comparison of the San Francisco Syncope Rule, Canadian Syncope Risk Score and Anatolian Syncope Rule in Patients Presenting to the Emergency Department with Syncope
Bibliographic record
Abstract
Objectives: Syncope is a common cause of emergency department admissions and poses challenges in patient management due to its broad etiology and risk of short-term adverse events. This study aimed to comparatively evaluate the ability of the San Francisco Syncope Rule, Canadian Syncope Risk Score and Anatolian Syncope Rule to predict short-term (1-week and 1-month) adverse events in patients presenting to the emergency department with syncope. Methods: This multicenter, prospective, observational study included 108 patients who presented to the emergency departments of two tertiary-level hospitals with syncope. Patients aged <18 years, pregnant women, those with non-syncopal causes of transient loss of consciousness, and those requiring hospitalization at presentation were excluded. Patients were contacted by phone on the 7th and 30th days after discharge to assess adverse events, including death, life-threatening arrhythmias, myocardial infarction, aortic dissection, pulmonary embolism, major bleeding, and subarachnoid hemorrhage. Results: The mean age was 45.9±18.9 years, and 57.4% were female. The most common comorbidity was hypertension (34.3%), and vasovagal syncope (47.2%) was the leading etiology. Within 1 week, 8 (7.4%) patients experienced adverse events; none occurred at 1 month. Median scores were 0 for the San Francisco Syncope Rule, 1 for the Anatolian Syncope Rule, and 0 for the Canadian Syncope Risk Score; among those with events: 0.5, 2, 3, respectively. Conclusions: The San Francisco Syncope Rule showed limited early discrimination, the Canadian Syncope Risk Score identified high-risk patients, and the Anatolian Syncope Rule better stratified low–moderate risk groups. Risk scores should complement, not replace, clinical judgment.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.000 | 0.004 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".