TY - JOUR T1 - Highlights from this issue JF - Emergency Medicine Journal JO - Emerg Med J SP - 491 LP - 491 DO - 10.1136/emermed-2022-212625 VL - 39 IS - 7 AU - Ellen J Weber Y1 - 2022/07/01 UR - http://emj.bmj.com/content/39/7/491.abstract N2 - Much of what emergency physicians do is assess risk. Sometimes it’s the likelihood of a diagnosis – does this chest pain represent ischaemic heart disease? And sometimes we know the diagnosis but not how likely the patient is to suffer adverse consequences if discharged home. Syncope, of course, is one where we usually know what happened but not the underlying aetiology, and thus, whether the episode can be evaluated on an outpatient basis. This has led to several decision rules which have had varying success in validation studies. In this issue, Thiruganasambandamoorthy and colleagues pooled data from two large cohort studies to come up with Canadian Syncope Risk Scores that suggest high, medium and low risk for 30 day serious outcomes after a syncopal episode. The authors created an on-line calculator and visual aids that are available to readers to us in patient discussions to allow shared decision making.Another knotty problem is judging whether the patient with chest pain has ACS and will suffer MACE in the next 30 days. A variety of approaches have been proposed and validated, most of which require one or … ER -