ArticleCephalalgia : an international journal of headache2015
Headache neuroimaging: Routine testing when guidelines recommend against them.
Article in Cephalalgia : an international journal of headache, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 50 citations in OpenAlex.
- Cumulative effective dose among 5.6 million CT exams in a multinational radiation dose registry.The British journal of radiology · 2026Article
- Neuroimaging markers of intracranial hypertension in cerebral venous thrombosis: A systematic review and meta-analysis.Surgical neurology international · 2025Review
- Migraine in the multiple sclerosis prodrome: a prospective nationwide cohort study in pregnant women.The journal of headache and pain · 2024Article
- Rationale for issuing neuroimaging requests for patients with primary headaches in China.Brain and behavior · 2024Article
- [Descriptive study of the alterations in neuroimaging tests in patients with headache in an outpatient setting].Revista de neurologia · 2023Observational
- The association between headache presentation, normal examination and neuroimaging findings: a retrospective analysis of patients presenting to a tertiary referral centre.African health sciences · 2022Article
- Article
- Headache neuroimaging: A survey of current practice, barriers, and facilitators to optimal use.Headache · 2022Article
- The management and clinical knowledge of headache disorders among general practitioners in Norway: a questionnaire survey.The journal of headache and pain · 2021Article
- Observational
- Factors Associated with Incidental Neuroimaging Abnormalities in New Primary Headache Patients.Journal of clinical neurology (Seoul, Korea) · 2020Article
- Factors associated with delayed diagnosis of migraine: A hospital-based cross-sectional study.Journal of family medicine and primary care · 2019Article
- Impact of early headache neuroimaging on time to malignant brain tumor diagnosis: A retrospective cohort study.PloS one · 2019Article
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- Article
- Article
- Neurology Choosing Wisely recommendations: 74 and growing.Neurology. Clinical practice · 2015Article
- Prevalence, management and burden of episodic and chronic headaches--a cross-sectional multicentre study in eight Austrian headache centres.The journal of headache and pain · 2015Article
- Portable Ultra-Low-Field MRI in Outpatient Neurology: An Examination of Clinical Performance and Patient Experience.Journal of neuroimaging : official journal of the American Society of NeuroimagingArticle
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
aimsThe aim of this article is to determine the patient-level factors associated with headache neuroimaging in outpatient practice.
methodsUsing data from the 2007-2010 National Ambulatory Medical Care Surveys (NAMCS), we estimated headache neuroimaging utilization (cross-sectional). Multivariable logistic regression was used to explore associations between patient-level factors and neuroimaging utilization. A Markov model with Monte Carlo simulation was used to estimate neuroimaging utilization over time at the individual patient level.
resultsMigraine diagnoses (OR = 0.6, 95% CI 0.4-0.9) and chronic headaches (routine, chronic OR = 0.3, 95% CI 0.2-0.6; flare-up, chronic OR = 0.5, 95% CI 0.3-0.96) were associated with lower utilization, but even in these populations neuroimaging was ordered frequently. Red flags for intracranial pathology did not increase use of neuroimaging studies (OR = 1.4, 95% CI 0.95-2.2). Neurologist visits (OR = 1.7, 95% CI 0.99-2.9) and first visits to a practice (OR = 3.2, 95% CI 1.4-7.4) were associated with increased imaging. A patient with new migraine headaches has a 39% (95% CI 24-54%) chance of receiving a neuroimaging study after five years and a patient with a flare-up of chronic headaches has a 51% (32-68%) chance.
conclusionsNeuroimaging is routinely ordered in outpatient headache patients including populations where guidelines specifically recommend against their use (migraines, chronic headaches, no red flags).
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