--- title: "Pt. decision aid for syncope in ER. | Sutter Health" description: "We iteratively developed an evidence-based decision aid to facilitate shared decision-making for alert syncope patients after an unremarkable ED evaluation." url: "https://www.sutterhealth.org/research/publications/pt-decision-aid-for-syncope-in-er-1055312333" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Pt. decision aid for syncope in ER. # Development of a patient decision aid for syncope in the emergency department: the SynDA tool. Probst MA, Hess EP, Breslin M, Frosch DL, Sun BC, Langan MN, & Richardson LD. _Acad Emerg Med. doi: 10.1111/acem.13373. \[Epub ahead of print\]_ 2017-12-30 ## Abstract OBJECTIVES: To develop a patient decision aid to promote shared decision-making for stable, alert patients who present to the emergency department (ED) with syncope. METHODS: Using input from patients, clinicians, and experts in the field of syncope, health care design, and shared decision-making, we created a prototype of a paper-based decision aid to engage patients in the disposition decision (admission vs. discharge) after an unremarkable ED evaluation for syncope. In phase 1, we conducted 1-on-1 semi-structured exploratory interviews with 10 emergency physicians and 10 ED syncope patients. In phase 2, we conducted 1-on-1 directed interviews with 15 emergency care clinicians, 5 cardiologists, and 12 ED syncope patients to get detailed feedback on decision aid content and design. We iteratively modified the aid using feedback from each interviewee until clarity and usability had been optimized. RESULTS: The 11- x 17-inch, paper-based decision aid, titled SynDA, includes 4 sections: 1) Explanation of syncope, 2) Explanation of future risks, 3) Personalized 30-day risk estimate, and 4) Disposition options. The personalized risk estimate is calculated using a recently published syncope risk-stratification tool. This risk estimate is stated in natural frequency and graphically displayed using a 100-person color-coded pictogram. Patient-oriented questions are included to stimulate dialogue between patient and clinician. At the end of the development process, patient and physician participants expressed satisfaction with the clarity and usability of the decision aid. CONCLUSIONS: We iteratively developed an evidence-based decision aid to facilitate shared decision-making for alert syncope patients after an unremarkable ED evaluation. Further testing is required to determine its effects on patient care. This decision aid has the potential to improve care for syncope patients and promote patient-centered care in emergency medicine. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29288554) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Process improvement: the sorcerer and the sorcerer's apprentice.](https://www.sutterhealth.org/research/publications/process-improvement-inpt-cardiac-operations-1055312402) Gaudiani VA. Rev Bras Cir Cardiovasc. 2009 Jan-Mar;24(1):1-3. 2009 Jan 01 - Publication ### [Predictors of statin compliance after switching from branded to generic agents among managed-care beneficiaries.](https://www.sutterhealth.org/research/publications/statin-compliance-predictors-branded-to-generic-1055312734) Romanelli RJ, Segal JB. J Gen Intern Med. \[Epub ahead of print\] 2014 Jun 24 - Publication ### [Improving adherence to best-practice guidelines for venous thromboembolism risk assessment and prevention.](https://www.sutterhealth.org/research/publications/improving-adherence-to-best-practice-in-vte-1055312724) Schiro TA, Sakowski J, Romanelli RJ, Jukes T, Newman J, Hudnut A, Leonard T. Am J Health Syst Pharm. 68(22):2184-9. doi: 10.2146/ajhp110102. 2011 Nov 15 - Publication ### [Moderating effects of patient characteristics on the impact of financial incentives.](https://www.sutterhealth.org/research/publications/effects-of-pt-characteristics-on-financial-incentives-1055312755) Rosenthal MB, Troxel AB, Volpp KG, Stewart WF, Sequist TD, Jones JB, Hirsch AG, Hoffer K, Zhu J, Wang W, Hodlofski A, Finnerty D, Huang JJ, Asch DA. Med Care Res Rev. 76(1):56-72. doi: 10.1177/1077558717707313. Epub 2017 May 8. 2019 Feb 01 - Publication ### [Multivariate analysis of factors associated with persistent colesevelam treatment among patients with hypercholesterolemia.](https://www.sutterhealth.org/research/publications/factors-associated-with-persistent-colesevelam-tx-1055312600) Romanelli RJ, Leahy A, Jukes T, Ye X, Kang A, Ishisaka DY. Ann Pharmacother. 47(10):1247-52. doi: 10.1177/1060028013501804. 2013 Oct 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/pt-decision-aid-for-syncope-in-er-1055312333#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Pt. decision aid for syncope in ER."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/pt-decision-aid-for-syncope-in-er-1055312333#medicalscholarlyarticle","name":"Development of a patient decision aid for syncope in the emergency department: the SynDA tool.","headline":"Pt. decision aid for syncope in ER.","abstract":"OBJECTIVES: To develop a patient decision aid to promote shared decision-making for stable, alert patients who present to the emergency department (ED) with syncope. METHODS: Using input from patients, clinicians, and experts in the field of syncope, health care design, and shared decision-making, we created a prototype of a paper-based decision aid to engage patients in the disposition decision (admission vs. discharge) after an unremarkable ED evaluation for syncope. In phase 1, we conducted 1-on-1 semi-structured exploratory interviews with 10 emergency physicians and 10 ED syncope patients. In phase 2, we conducted 1-on-1 directed interviews with 15 emergency care clinicians, 5 cardiologists, and 12 ED syncope patients to get detailed feedback on decision aid content and design. We iteratively modified the aid using feedback from each interviewee until clarity and usability had been optimized. RESULTS: The 11- x 17-inch, paper-based decision aid, titled SynDA, includes 4 sections: 1) Explanation of syncope, 2) Explanation of future risks, 3) Personalized 30-day risk estimate, and 4) Disposition options. The personalized risk estimate is calculated using a recently published syncope risk-stratification tool. This risk estimate is stated in natural frequency and graphically displayed using a 100-person color-coded pictogram. Patient-oriented questions are included to stimulate dialogue between patient and clinician. At the end of the development process, patient and physician participants expressed satisfaction with the clarity and usability of the decision aid. CONCLUSIONS: We iteratively developed an evidence-based decision aid to facilitate shared decision-making for alert syncope patients after an unremarkable ED evaluation. Further testing is required to determine its effects on patient care. 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