Supplementary Appendix 1. List of included studies. (S1) Agarwal D, Serrano LA, Bellolio M, Jain A, Sandefur BJ, Stead LG, et al. Electrocardiographic intervals and one-year cardiovascular outcomes in syncope. Annals of Emergency Medicine 2009;54(3 SUPPL. 1):S118. (S2) Birnbaum A, Esses D, Bijur P, Wollowitz A, Gallagher EJ. Failure to validate the San Francisco Syncope Rule in an independent emergency department population. Ann Emerg Med 2008 Aug;52(2):151-9. (S3) Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M. Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score. Eur Heart J 2003 May;24(9):811-9. (S4) Cosgriff TM, Kelly AM, Kerr D. External validation of the San Francisco Syncope Rule in the Australian context. CJEM 2007 May;9(3):157-61. (S5) Costantino G, Perego F, Dipaola F, Borella M, Galli A, Cantoni G, et al. Short- and long-term prognosis of syncope, risk factors, and role of hospital admission: results from the STePS (ShortTerm Prognosis of Syncope) study. J Am Coll Cardiol 2008 Jan 22;51(3):276-83. (S6) Crane SD. Risk stratification of patients with syncope in an accident and emergency department. Emerg Med J 2002 Jan;19(1):23-7. (S7) Day SC, Cook EF, Funkenstein H, Goldman L. Evaluation and outcome of emergency room patients with transient loss of consciousness. Am J Med 1982 Jul;73(1):15-23. (S8) Eagle KA, Black HR, Cook EF, Goldman L. Evaluation of prognostic classifications for patients with syncope. Am J Med 1985 Oct;79(4):455-60. (S9) Grossman SA, Fischer C, Lipsitz LA, Mottley L, Sands K, Thompson S, et al. Predicting adverse outcomes in syncope. J Emerg Med 2007 Oct;33(3):233-9. (S10) Han H, Santos M. Long-term outcomes of patients presenting with syncope to a major victorian emergency department. Heart Lung and Circulation 2010;19 SUPPL. 2:S221. (S11) Kayayurt K, Akoglu H, Limon O, Ergene AO, Yavasi O, Bayata S, et al. Comparison of existing syncope rules and newly proposed anatolian syncope rule to predict shortterm serious outcomes after syncope in the Turkish population. International Journal of Emergency Medicine 2012;5(1 Article Number). (S12) Long BJ, Serrano LA, Chandra S, Bellollio M, Agarwal D, Decker WW, et al. Does mode of transportation to the emergency department predict subsequent cardiopulmonary adverse events in patients with syncope? Annals of Emergency Medicine 2011;58(4 SUPPL. 1):S260. (S13) Martin GJ, Adams SL, Martin HG, Mathews J, Zull D, Scanlon PJ. Prospective evaluation of syncope. Ann Emerg Med 1984 Jul;13(7):499-504. (S14) Martin TP, Hanusa BH, Kapoor WN. Risk stratification of patients with syncope. Ann Emerg Med 1997 Apr;29(4):459-66. (S15) Quinn J, McDermott D, Kramer N, Yeh C, Kohn MA, Stiell I, et al. Death after emergency department visits for syncope: how common and can it be predicted? Ann Emerg Med 2008 May;51(5):585-90. (S16) Racco F, Sconocchini C, Reginelli R, Brizzi G, Alesi C, Rosati S, et al. [Syncope in a general population: etiologic diagnosis and follow-up. Results of a prospective study]. Minerva Med 1993 May;84(5):249-61. (S17) Reed MJ, Newby DE, Coull AJ, Jacques KG, Prescott RJ, Gray AJ. Role of brain natriuretic peptide (BNP) in risk stratification of adult syncope. Emerg Med J 2007 Nov;24(11):769-73. (S18) Reed MJ, Newby DE, Coull AJ, Prescott RJ, Jacques KG, Gray AJ. The ROSE (risk stratification of syncope in the emergency department) study. J Am Coll Cardiol 2010 Feb 23;55(8):713-21. (S19) Reed MJ, Henderson SS, Newby DE, Gray AJ. One-year prognosis after syncope and the failure of the ROSE decision instrument to predict one-year adverse events. Ann Emerg Med 2011 Sep;58(3):250-6. (S20) Rodriguez-Entem F, Gonzalez-Enriquez S, Olalla-Antolin JJ, Cobo-Belaustegui M, ExpositoGarcia V, Llano-Cardenal M, et al. [Management of syncope in the emergency department without hospital admission: usefulness of an arrhythmia unit coordinated protocol]. Rev Esp Cardiol 2008 Jan;61(1):22-8. (S21) Romero-Rodriguez N, Baron-Esquivias G, Gomez-Moreno S, Arjona BJ, Pedrote A, Martinez MA. Evaluation of high risk syncope referred from emergency department. Revista Clinica Espanola 2010 Feb;210(2):70-4. (S22) Sarasin FP, Louis-Simonet M, Carballo D, Slama S, Rajeswaran A, Metzger JT, et al. Prospective evaluation of patients with syncope: a population-based study. Am J Med 2001 Aug 15;111(3):17784. (S23) Tan C, Sim TB, Thng SY. Validation of the San Francisco syncope rule in two local hospitals emergency departments. Academic Emergency Medicine 2012 Jun;19(6):743. (S24) Ungar A, Del RA, Giada F, Bartoletti A, Furlan R, Quartieri F, et al. Early and late outcome of treated patients referred for syncope to emergency department: The EGSYS 2 follow-up study. European Heart Journal 2010 Aug;31(16):2021-6. (S25) Wagner P, Bucher HC, Bucheli B, Battegay E, Martina B. Predictors of hospitalization in emergency department patients with syncope. Eur J Intern Med 2000;11(1):39-44.