Implementing a risk score for patients with syncope in emergency departments

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial aims to implement the Canadian Syncope Risk Score (CSRS) in emergency departments across Canada to improve decision-making for patients presenting with syncope. The study will involve a stepped-wedge cluster randomized trial design, where 16 emergency department clusters will sequentially transition from usual care to the CSRS-based intervention over a total duration of 16 months. The primary focus is to assess the impact of this implementation on health resource utilization and patient outcomes, particularly in reducing unnecessary hospitalizations. The trial will also evaluate the effectiveness of knowledge translation strategies in enhancing the adoption of the CSRS recommendations in clinical practice.

Why it matters

Who can join: the full rules

Physicians:

Inclusion criteria:

* ED physicians involved in ED syncope care
* Non-ED physicians involved in ED syncope care
* Physician's delegates involved in ED syncope care

Exclusion criteria:

* ED physicians not involved in ED syncope care
* Non-ED physicians not involved in ED syncope care
* Physician's delegates not involved in ED syncope care

Patients:

Inclusion criteria:

* Patients who are adults (aged \> 18 years)
* Patients who present to the ED within 24 hours of syncope.

Exclusion criteria:

* Patients who do not fulfill the definition of syncope, namely those with a prolonged loss of consciousness (i.e., \> 5 minutes), Glasgow Coma Scale \< 15 in patients without dementia (or a change in the mental status from baseline in those with dementia);
* Patients with witnessed obvious seizure, or head trauma preceding the loss of consciousness; and those who are unable to provide proper details (e.g., alcohol intoxication or other substance use).
* Patients who had a serious underlying for the syncope identified during the index ED evaluation and those who were consulted to an inpatient service or hospitalized for reasons other than syncope workup (e.g., social reasons such as inability to cope at home, pain due to the fall, significant trauma).

Where it's running

• Foothills Medical Centre
  Calgary, Alberta, Canada Recruiting
• St. Boniface Hospital
  Winnipeg, Manitoba, Canada Recruiting
• Health Sicence North
  Greater Sudbury, Ontario, Canada Recruiting
• Hawkesbury and District General Hospital
  Hawkesbury, Ontario, Canada Recruiting
• London Health Sciences Centre
  London, Ontario, Canada Recruiting
• North Bay Regional Health Centre
  North Bay, Ontario, Canada Recruiting

Study contacts

• Principal investigator: Venkatesh Thiruganasambandamoorthy, CCFP-EM, MSc — Ottawa Hospital Research Institute
• Study coordinator: Iris Nguyen, BSc
• Email: pnguyen@ohri.ca
• Phone: 6137985555

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.