Parenteral NSAIDs for acute treatment of migraine: Adherence to the IHS guidelines for controlled trials

Cephalalgia Reports

article

Maria Susanne Neumeier¹  Miranda Stattmann¹  Susanne Wegener¹  Andreas R Gantenbein¹  Heiko Pohl¹ 

[1] Department of Neurology, University Hospital Zurich;Department of Neurology

关键词: diagnosis;    headache classification;    interrater reliability;    noise;    primary headache;    secondary headache;   

DOI  :  10.1177/25158163221115391

学科分类：兽医学

来源: Sage Journals

【 摘 要 】

Background: Diagnosing headache disorders comprises the collection and interpretation of information. This studyestimates agreement and bias in the latter.Methods: Physicians and medical students diagnosed eight patients’ headaches using the International Classification ofHeadache Disorders. We calculated Cohen’s Kappa for all participants and subgroups (board-certified neurologists,physicians working in a neurology department). Moreover, we asked how sure they felt about their diagnoses. Finally,participants estimated the number of different headache diagnoses a patient receives when consulting many physicians forthe same headache and indicated the highest acceptable number.Results: The data of 63 participants entered the analysis, of whom 18 were neurologists (18/63, 28.6%), and 41 werecurrently working at a neurology clinic (41/63, 66.7%). Cohen’s Kappa decreased (0.706, 0.566, and 0.408) with increasinglevels of the classification hierarchy. Interrater agreement was highest among neurologists. Physicians not working in aneurology clinic tended to diagnose secondary headaches more often were less confident about their diagnoses.Conclusions: Physicians with less experience in headache disorders struggle more to diagnose headaches than neurologists do; they suspect secondary headaches, disagree, and feel insecure more often. Thus, interpreting a headachehistory is prone to error and bias.

【 授权许可】

CC BY-NC