The San Francisco Syncope Rule (CHESS)

The San Francisco Syncope Rule (CHESS)

The criteria demonstrated 96% sensitivity (95% confidence interval [CI], 92% to 100%) and 62% specificity (95% CI, 58% to 66%) for serious outcomes at 7 days

Stickberger SA, Benson W, Biaggioni I, et al. AHA/ACCF scientific statement on the evaluation of syncope. J Am Coll Cardiol. 2006;12:473-484

Caution:

Up to 11% of patients discharged home with 0 out of 5 on the “CHESS” algorithm may still have a serious outcome as defined in the study within 30 days — an unacceptably high risk

Miller CD, Hoekstra JW. Prospective validation of the San Francisco Syncope Rule: Will it change practice [Editorial]? Ann Emerg Med. 2006;47:455-456