{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:36:59Z","timestamp":1787499419367,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,2,23]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Pediatric syncope is common. Cardiac causes are rarely found. We describe and assess a pragmatic approach to these patients first seen by a pediatric cardiologist in the New England region, using Standardized Clinical Assessment and Management Plans (\n                      <jats:styled-content style=\"fixed-case\">SCAMP<\/jats:styled-content>\n                      s).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Ambulatory patients aged 7 to 21\u00a0years initially seen for syncope at participating New England Congenital Cardiology Association practices over a 2.5\u2010year period were evaluated using a\n                      <jats:styled-content style=\"fixed-case\">SCAMP<\/jats:styled-content>\n                      . Findings were iteratively analyzed and the care pathway was revised. The vast majority (85%) of the 1254 patients had typical syncope. A minority had exercise\u2010related or more problematic symptoms. Guideline\u2010defined testing identified one patient with cardiac syncope. Syncope Severity Scores correlated well between physician and patient perceived symptoms. Orthostatic vital signs were of limited use. Largely incidental findings were seen in 10% of\n                      <jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content>\n                      s and 11% of echocardiograms. The 10% returning for follow\u2010up, by design, reported more significant symptoms, but did not have newly recognized cardiac disease. Iterative analysis helped refine the approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      <jats:styled-content style=\"fixed-case\">SCAMP<\/jats:styled-content>\n                      methodology confirmed that the vast majority of children referred to the outpatient pediatric cardiology setting had typical low\u2010severity neurally mediated syncope that could be effectively evaluated in a single visit using minimal resources. A simple scoring system can help triage patients into treatment categories. Prespecified criteria permitted the effective diagnosis of the single patient with a clear cardiac etiology. Patients with higher syncope scores still have a very low risk of cardiac disease, but may warrant attention.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.115.002931","type":"journal-article","created":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T09:11:36Z","timestamp":1536916296000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Regional Implementation of a Pediatric Cardiology Syncope Algorithm Using Standardized Clinical Assessment and Management Plans (SCAMPS) Methodology"],"prefix":"10.1161","volume":"5","author":[{"given":"Yvonne","family":"Paris","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Baystate Medical Center, Springfield, MA"},{"name":"Department of Pediatrics, Tufts Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga 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