MISSION Syncope

Functionality & Mechanism

MISSION Syncope is a clinical decision support tool designed to standardize the evaluation and management of syncope. The interface mirrors a real-world clinical workflow, guiding the clinician through sequential modules for patient assessment, differential diagnosis (DDx), risk stratification, and management recommendations. The system leverages published likelihood ratios to generate a ranked DDx and integrates the Canadian Syncope Score to facilitate prognosis. Recommendations are explicitly aligned with established clinical practice guidelines to support evidence-based decision-making at the point of care.

Evidence & Research Context

• The app was developed to translate American College of Cardiology/American Heart Association (ACC/AHA) Syncope Guideline recommendations into a point-of-care tool aimed at standardizing practice and reducing service overuse.
• Its internal differential diagnosis model was validated pragmatically through an iterative review process applying the logic to actual clinical cases, as described in the app's development protocol.
• A user-centered design process involving observations, storyboarding, and beta-testing with clinicians established the tool's functionality and usability within emergency department workflows.
• The app is one component of the broader, multicomponent MISSION implementation strategy, which a pilot study found to be feasible, acceptable, and show initial success in promoting appropriate testing.

Intended Use & Scope

This tool is intended for use by medical professionals to augment clinical evaluation of patients presenting with syncope. Its primary utility is as an adjunct for formulating a differential diagnosis and assessing prognosis. The app does not replace professional clinical judgment, provide a definitive diagnosis, or constitute medical advice. Clinicians must synthesize the tool's output with their own comprehensive patient assessment.