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Diagnostic Imaging for Uncomplicated Headache

Diagnostic imaging is not indicated in low risk headache patients with no red flags. The project aims to determine the incidence of diagnostic imaging for low-risk headache patients seen by primary care physicians.

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Choosing Wisely | Family Medicine, Neurology

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Don’t order neuroimaging or sinus imaging in patients who have a normal clinical examination, who meet diagnostic criteria for migraine, and have no “red flags” for a secondary headache disorder.


CHOOSING WISELY CANADA RECOMMENDATION

Project Leads

Dr. Lara Cooke, Associate Dean Continuing Medical Education and Professional Development, University of Calgary



Dr. Shawn Dowling, Medical Director-Specialty Medicine, Physician Learning Program

Project Manager - Ashi Mehta


Background

Diagnostic imaging is not indicated in low risk headache patients with no red flags.  Determine the incidence of diagnostic imaging for “low-risk” headache patients seen by primary care physicians.


  • Evaluate patients 18 to 50 years old diagnoses with a headache in Primary Care

  • Remove patients with co-morbidities or red flags

  • Identify low risk patient cohort receiving head DI – deemed possibly not required

Determine the frequency of potentially inappropriate diagnostic imaging (ie. CT head, MRI brain or sinus x-rays) in patients with “low-risk” headaches in the Primary Care setting.



Intended Outcome

Report and analyze aggregate data for diagnostic imaging rates in patients who present to a primary care physician for a “low-risk” headache.






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References

Becker WJ, Findlay T, Moga C, Scott NA, Harstall C, Taenzer P. Guideline for primary care management of headache in adults. Can Fam Physician. 2015 Aug;61(8):670-9. 



Sempere AP, Porta-Etessam J, Medrano V, et al. Neuroimaging in the evaluation of patients with non-acute headache. Cephalalgia. 2005 Jan;25(1):30-5.

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