Evidence map›Paper›PMID 30707721›Full record

ArticlePloS one2019

Impact of early headache neuroimaging on time to malignant brain tumor diagnosis: A retrospective cohort study.

Matthew R Carey, Brian C Callaghan, Kevin A Kerber, Lesli E Skolarus, James F Burke

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Matthew R CareyUniversity of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, United States of America.ORCID 0000-0002-5838-8437
Brian C CallaghanDepartment of Neurology, University of Michigan, Ann Arbor, Michigan, United States of America.
Kevin A KerberDepartment of Neurology, University of Michigan, Ann Arbor, Michigan, United States of America.
Lesli E SkolarusDepartment of Neurology, University of Michigan, Ann Arbor, Michigan, United States of America.
James F BurkeDepartment of Neurology, University of Michigan, Ann Arbor, Michigan, United States of America.
University of Michigan · US

Funding

Reach Out: Randomized Clinical Trial of Emergency Department-Initiated Hypertension Behavioral Intervention Connecting Multiple Health SystemsR01MD011516 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MEURER, WILLIAM JOSEPH, SKOLARUS, LESLI ELIZABETH · 2017 to 2020
$3.3M
A Community Based Participatory Trial to Increase Stroke TreatmentU01MD010579 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BROWN, DEVIN L · 2016 to 2020
$2.8M
NIMHD NIH HHS R01 MD011516NIMHD NIH HHS U01 MD010579
6 · The paper itself

Abstract

backgroundNeuroimaging for headaches is both common and costly. While the costs are well quantified, little is known about the benefit in terms of diagnosing pathology. Our objective was to determine the role of early neuroimaging in the identification of malignant brain tumors in individuals presenting to healthcare providers with headaches.

methodsThis was a retrospective cohort study using administrative claims data (2001-2014) from a US insurer. Individuals were included if they had an outpatient visit for headaches and excluded for prior headache visits, other neurologic conditions, neuroimaging within the previous year, and cancer. The exposure was early neuroimaging, defined as neuroimaging within 30 days of the first headache visit. A propensity score-matched group that did not undergo early neuroimaging was then created. The primary outcome was frequency of malignant brain tumor diagnoses and median time to diagnosis within the first year after the incident headache visit. The secondary outcome was frequency of incidental findings.

results22.2% of 180,623 individuals had early neuroimaging. In the following year, malignant brain tumors were found in 0.28% (0.23-0.34%) of the early neuroimaging group and 0.04% (0.02-0.06%) of the referent group (P<0.001). Median time to diagnosis in the early neuroimaging group was 8 (3-19) days versus 72 (39-189) days for the referent group (P<0.001). Likely incidental findings were discovered in 3.17% (3.00-3.34%) of the early neuroimaging group and 0.66% (0.58-0.74%) of the referent group (P<0.001).

conclusionsMalignant brain tumors in individuals presenting with an incident headache diagnosis are rare and early neuroimaging leads to a small reduction in the time to diagnosis.

Indexed as

AdolescentAdultAgedBrain NeoplasmsCohort StudiesDatabases, FactualFemaleHeadacheHumansMaleMiddle AgedNeoplasmsNeuroimagingNeurologic ExaminationRetrospective StudiesTime Factors

Identifiers

PMID30707721
PMCPMC6358089
OpenAlexW2912182230

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.