Why do GPs with a special interest in headache investigate headache presentations with neuroradiology and what do they find?

The Journal of Headache and Pain

Original

Steven Elliot¹  David Kernick² 

[1] Horizon Centre, 94 Littleton Road, M7 3SE, Salford, UK;St Thomas Health Centre, Cowick Street, EX4 1HJ, Exeter, UK;

关键词: Headache;    Neuroradiology;    Primary care;   

DOI  :  10.1007/s10194-011-0375-8

 received in 2011-06-16, accepted in 2011-07-22,  发布年份 2011

来源: Springer

【 摘 要 】

The general practitioner with a special interest in headache offers an important contribution to the management of headache in primary care where the majority of presentations take place. A number of guidelines have been developed for neuroradiological investigation of headache, but their clinical utility and relevance is not known. Fourteen general practitioners with a special interest in headache recorded consecutive headache consultations over a 3-month period, whether patients were investigated with neuroradiology and if so the reason for investigation and outcome. Reason for investigation was compared to the guidelines published for the use in primary care. 895 patients were seen, of whom 270 (30.1%) were investigated. 47% of indications were outside the guidance framework used, the most common reason for investigation being reassurance. Of those investigated, 5.6% showed positive findings but only 1.9% of findings were felt to be of clinical significance. General practitioners with a special interest investigated with neuroradiology a greater level than general practitioners, but less than neurologists. However, yields of significant findings are broadly comparative across all groups. This report confirms other studies that suggest that even when there is a high level of clinical suspicion, yields of significant findings are very low.

【 授权许可】

CC BY   
© The Author(s) 2011