Nonexpert Clinicians Lack Tools for Diagnosing Headache Disorders
There are no validated tools in primary care to classify chronic headache disorders that allow clinicians to screen for primary headaches other than migraine and TTH.
Primary care physicians may need specialized tools to diagnose, manage, and refer patients with headache disorders to appropriate specialists, according to the results of a literature review published in Cephalalgia.
Researchers reviewed 38 studies published between 1988 and mid-2016 that validated tools for diagnosing and classifying headaches. They also studied 30 separate diagnostic tools drawn from these studies. Quality assessment relied on using items from the Quality of Diagnostic Accuracy Studies (QUADAS-2).
The tools studied were validated in headache clinic settings (n=14), through general health or household surveys (n=6), at neurology clinics or departments (n=5), in primary care settings (n=4), in emergency care settings (n=3), in community settings (n=2), and elsewhere.
Some tools were valid in multiple settings or overlapping settings. However, researchers could find no valid diagnostic tool that helped nonexpert clinicians to diagnose, treat, or refer patients with headache disorder outside of migraine or tension headaches.
According to researchers, “the availability of such a tool could support primary care clinicians in diagnosing and managing chronic headache disorders within primary care.”
Potter R, Probyn K, Bernstein C, et al. Diagnostic and classification tools for chronic headache disorders: a systematic review [published online October 18, 2018]. Cephalalgia. doi: 10.1177/0333102418806864