The heart of F2 Solutions’ technology is a sophisticated set of algorithms developed to help with the management of patients presenting with Faint or Fall. It was validated retrospectively and will be used in the new "Faint and Fall Clinic" at the University of Utah.

The guideline-based algorithms for patients presenting with a Faint or Fall were developed jointly by Dr. Hamdan and Dr. Brignole, drawing on their combined decades of actual clinical experience in treating thousands of patients with Faint or Fall. The algorithms are highly sophisticated and incorporate widely accepted, published standards of medical practice for diagnosing and managing patients with Faint or Fall.


Mohamed H. Hamdan MD, MBA, FACC, FHRS

Dr. Hamdan is the Tuchman Chair of Cardiology and Chief of Cardiovascular Medicine at the University of Wisconsin. Dr. Hamdan currently holds the Mildred & Marv Conney Endowed Chair in the name of the Chief of Cardiology. He completed his Internal Medicine Residency at the University of Iowa, and Fellowships in Cardiology and Cardiac Electrophysiology at Stanford and the University of California, San Francisco. Dr. Hamdan is an internationally recognized expert in cardiac arrhythmias, with a research focus on atrial fibrillation and the autonomic nervous system. He has published over 65 original research manuscripts and has authored 20 review articles and book chapters. Dr. Hamdan has served as a peer reviewer for the Department of Veterans Affairs, the American Heart Association and the NHLBI, and is a member on the Board of Trustees for the Heart Rhythm Society. In recent years, he has developed an interest in decision support systems for diagnosis and treatment of patients with loss of consciousness and falls.

Michele Brignole MD, FESC

Dr. Brignole is Chief of the Division of Cardiology at Ospedali del Tigullio, Lavagna, Italy . He has distinguished himself as the author of many articles and chapters in textbooks on patients with Faint and Fall. One of the most recent chapters he wrote is “Syncope”, published in the European Society of Cardiology Textbook of Cardiovascular Medicine, January 1, 2009. He was Chairman and Member of the European Society of Cardiology Task Force on Syncope in writing “Guidelines On The Management (diagnosis and treatment) Of Syncope for the 2001, 2004, and 2009 editions. Dr. Brignole’s research and clinical interests have focused heavily on the mechanisms and detection of syncope, as well as the utilization of implantable and external loop recorders in the diagnosis of unexplained syncope.


Despite recently published guidelines, the evaluation and treatment of patients with a faint or a fall event are often haphazard and un-stratified. The result is inappropriate use of diagnostic tests and a high rate of misdiagnosis. In a recent study at the University of Utah, there was underutilization of lower cost diagnostic procedures such as orthostatic testing, carotid sinus massage, and implantable loop recorder and overutilization of more expensive tests such as imaging studies and neurologic consultation.

In another study including a total of 254 patients presenting to the Emergency Department, the number of inappropriate admissions and discharges was 69 out of 118 (58%) and 8 out of 136 (6%) respectively. The prevalence of serious events (SE) in the inappropriately admitted group (n=69) was not significantly different than in the appropriately discharged group (n=128) (4% versus 3%, p=NS). Similarly, the prevalence of SE in the inappropriately discharged group (n=8) was not significantly different than in the appropriately admitted group (n=49)(13% versus 16%, p=NS).


The F2 Solutions’ algorithms were developed to improve the management of patients with Faint or Fall. The decision-support algorithms used in this web-based application were meticulously and carefully developed by culling the most current and widely-accepted-guidelines and standards of medical practice from published literature. The information in these articles is heavily peer-reviewed and carefully validated before being approved for publication.

The utilization of these guideline-based algorithms should result in a significant reduction in the number of inappropriate admissions without increasing the incidence of serious events. In addition, it should result in a decrease in the number of inappropriate discharges thus improving patient care while reducing cost, a much-needed approach in the current financial climate.