Abstract
While reading Drs. Quinn and McDermott’s letter to the editor, I fear our opinion of the San Francisco Syncope Rule validation study may have been ambiguous and appreciate the opportunity for clarification. Our editorial is in agreement with the views expressed by Dr. Quinn. We both agree upon the importance of not using this decision rule “up-front” as this differs from how the rule was derived and validated. Furthermore, we also pointed out the limitations of allowing a decision rule to supersede clinical judgment and strongly agree this clinical decision rule should not be used in this manner. Thus, it was not our intent to suggest the manner in which the San Francisco Syncope Rule should be applied. In fact, to the contrary, our editorial intended to focus on the potential for misuse of clinical decision rules including the San Francisco Syncope Rule. Finally, Dr. Quinn and colleagues should be commended for this work which undoubtedly will assist in the risk stratification of patients with this potentially deadly symptom. While reading Drs. Quinn and McDermott’s letter to the editor, I fear our opinion of the San Francisco Syncope Rule validation study may have been ambiguous and appreciate the opportunity for clarification. Our editorial is in agreement with the views expressed by Dr. Quinn. We both agree upon the importance of not using this decision rule “up-front” as this differs from how the rule was derived and validated. Furthermore, we also pointed out the limitations of allowing a decision rule to supersede clinical judgment and strongly agree this clinical decision rule should not be used in this manner. Thus, it was not our intent to suggest the manner in which the San Francisco Syncope Rule should be applied. In fact, to the contrary, our editorial intended to focus on the potential for misuse of clinical decision rules including the San Francisco Syncope Rule. Finally, Dr. Quinn and colleagues should be commended for this work which undoubtedly will assist in the risk stratification of patients with this potentially deadly symptom. Medical Decisionmaking and the San Francisco Syncope RuleAnnals of Emergency MedicineVol. 48Issue 6PreviewWe would like to thank Drs. Miller and Hoekstra for their generally positive editorial of our work; however, we disagree how with how they suggest the San Francisco Syncope Rule may be used.1,2 Full-Text PDF
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