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Costs and utility of tests in the evaluation of the pediatric patients with syncope

L A. Steinberg1, T K. Knilans

  • 1The Heart Center, Children's Hospital Medical Center, OSB 4, Division of Cardiology, 3333 Burnet Avenue, 45229-3039, Cincinnati, OH, USA

Progress in Pediatric Cardiology
|July 18, 2001
PubMed

Insights

Diagnosing pediatric syncope (fainting) can be costly. A targeted testing approach, guided by patient history, physical exam, and electrocardiogram, can reduce costs and identify serious conditions.

Area of Science:

  • Pediatric Cardiology
  • Diagnostic Medicine
  • Clinical Evaluation

Background:

  • Syncope (fainting) in children presents diagnostic challenges.
  • New diagnostic tests improve cause identification but increase healthcare costs.
  • Effective syncope evaluation aims to find treatable causes and assess sudden death risk.

Purpose of the Study:

  • To review the diagnostic utility of common tests for pediatric syncope.
  • To propose a cost-effective, directed approach to syncope evaluation in children.
  • To identify strategies for reducing unnecessary diagnostic testing.

Main Methods:

  • Literature review of diagnostic tests for pediatric syncope.
  • Analysis of the diagnostic yield of commonly used tests in unselected pediatric populations.
  • Evaluation of a history, physical examination, and electrocardiogram-based directed testing strategy.

Main Results:

  • Many diagnostic tests have a low yield in unselected pediatric syncope patients.
  • A directed diagnostic approach, based on initial clinical assessment, is likely to be more cost-effective.
  • This approach aims to maintain the identification of life-threatening conditions.

Conclusions:

  • A history, physical examination, and electrocardiogram-guided approach can reduce costs for pediatric syncope evaluation.
  • Further prospective studies are needed to validate this directed testing strategy.
  • Optimizing diagnostic pathways is crucial for managing pediatric syncope effectively.

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