Table 6Diagnostic test accuracy statistics for initial assessment rules for vasovagal syncope

StudySens (%)Spec (%)LR+LRDiag Yield (%)
Graf 200893
Initial symptoms decision rule VV/Psychogenic model; validation cohort.
Low quality evidence (indirect target condition)
84 (64–95)50 (34–66)1.7 (1.2–2.4)0.32 (0.12–0.83)63
Sheldon 2006201
Initial symptoms decision rule for vasovagal syncope; cut-off above -2.
Low quality evidence in case control study (no structural heart disease or tilt negative unexplained syncope)
89 (85–93)91 (83–96)9.8 (5.1–19.1)0.12 (0.08–0.17)67
Romme 2009187
Validation of Sheldon 2006201 rule in van
Dijk 2008215 population
Moderate quality evidence; 25% patients excluded (CMO, MI, epileptic seizures, unknown cause after 2y)
87 (82–91)31 (24–40)1.3 (1.1–1.4)0.42 (0.28–0.62)80
van Dijk 2008215
Initial evaluation based on ESC guidelines certain only
moderate quality evidence
97 (91–100)100 (98–100)208.3 (52.2–830.6)0.03 (0.01–0.11)19
van Dijk 2008215
Initial evaluation based on ESC guidelines.
Highly likely only
moderate quality evidence
98 (93–100)97 (94–98)30.4 (17.4–53.2)0.02 (0.01–0.07)27
van Dijk 2008215
Initial evaluation based on ESC guidelines certain and highly likely
moderate quality evidence
98 (94–99)95 (92–97)20.8 (12.5–34.8)0.03 (0.01–0.06)42

From: 3, Initial assessment and diagnosis of people who had TLoC

Cover of Transient Loss of Consciousness (‘Blackouts’) Management in Adults and Young People
Transient Loss of Consciousness (‘Blackouts’) Management in Adults and Young People [Internet].
NICE Clinical Guidelines, No. 109.
National Clinical Guideline Centre for Acute and Chronic Conditions (UK).
Copyright © National Clinical Guideline Centre for Acute and Chronic Conditions, 2010.

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