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The diagnosis of cardiac syncope remains a challenge in the emergency department (ED). Assessing the diagnostic accuracy of the early standardized clinical judgement (ESCJ) including a standardized syncope-specific case report form (CRF) in comparison with a recommended multivariable diagnostic score. In a prospective international observational multicentre study, diagnostic accuracy for cardiac syncope of ESCJ by the ED physician amongst patients≥40years presenting with syncope to the ED was directly compared with that of the Evaluat