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Patients 12\u00a0years old and below and patients with loss of consciousness after head trauma, a witnessed seizure, with known alcohol or illicit drug ingestion, and altered level of consciousness or persistent new neurologic deficits were excluded. The patients were evaluated for the presence of one or more of the five <jats:styled-content style=\"fixed-case\">SFSR<\/jats:styled-content> variables: shortness of breath, history of heart failure, hematocrit &lt;30%, systolic blood pressure &lt;90\u00a0mm\u00a0Hg, and abnormal electrocardiogram (<jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content>). The patients were followed up by medical record review or telephone interview. Seven\u2010day outcomes were death, arrhythmia, myocardial infarction, acute pulmonary edema, significant structural heart disease, pulmonary embolism, major cardiac procedure, stroke, subarachnoid hemorrhage, major bleeding, and anemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,250 patients from two centers were recruited. Fifty\u2010six patients were excluded from primary analysis because of incomplete data (<jats:italic>n\u00a0=<\/jats:italic>\u00a055) and\/or they were noncontactable for follow\u2010up (<jats:italic>n\u00a0=<\/jats:italic>\u00a032). Of the 1,194 patients analyzed, 138 patients (11.6%) experienced adverse outcomes at 7\u00a0days. The rule performed with a sensitivity of 94.2% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]\u00a0=\u00a089.0% to 97.0%) and a specificity of 50.8% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a047.7% to 53.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, <jats:styled-content style=\"fixed-case\">SFSR<\/jats:styled-content> rule had a sensitivity of 94.2%. This suggests caution on the strict application of the rule to all patients presenting with syncope. It should only be used as an aide in clinical decision\u2010making in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12130","type":"journal-article","created":{"date-parts":[[2013,5,14]],"date-time":"2013-05-14T15:59:48Z","timestamp":1368547188000},"page":"487-497","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Validation of the San Francisco Syncope Rule in Two Hospital Emergency Departments in an Asian Population"],"prefix":"10.1111","volume":"20","author":[{"given":"Camlyn","family":"Tan","sequence":"first","affiliation":[{"name":"Emergency Medicine Department Changi General Hospital  2 Simei Street 3 Singapore 529889"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiong Beng","family":"Sim","sequence":"additional","affiliation":[{"name":"Emergency Medicine Department National University Health System Yong Loo Lin School of Medicine  21 Lower Kent Ridge Road Singapore 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