Consistency between headache diagnoses and ICHD-3 criteria across different levels of care
Abstract Background Diagnosing headache disorders poses significant challenges, particularly in primary and secondary levels of care (PSLC), potentially leading to misdiagnosis and underdiagnosis. This study evaluates diagnostic agreement for migraine, tension-type headache (TTH), and cluster headac...
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BMC
2025-01-01
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| Series: | The Journal of Headache and Pain |
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| Online Access: | https://doi.org/10.1186/s10194-024-01937-6 |
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| author | Lucas Hendrik Overeem Marlene Ulrich Mira Pauline Fitzek Kristin Sophie Lange Ja Bin Hong Uwe Reuter Bianca Raffaelli |
| author_facet | Lucas Hendrik Overeem Marlene Ulrich Mira Pauline Fitzek Kristin Sophie Lange Ja Bin Hong Uwe Reuter Bianca Raffaelli |
| author_sort | Lucas Hendrik Overeem |
| collection | DOAJ |
| description | Abstract Background Diagnosing headache disorders poses significant challenges, particularly in primary and secondary levels of care (PSLC), potentially leading to misdiagnosis and underdiagnosis. This study evaluates diagnostic agreement for migraine, tension-type headache (TTH), and cluster headache (CH) between PSLC and tertiary care (TLC) and assesses adherence to the International Classification of Headache Disorders 3rd edition (ICHD-3) guidelines. Methods A retrospective, cross-sectional analysis was conducted at Charité - Universitätsmedizin Berlin’s tertiary headache center. The patients’ self-reported diagnoses from the PSLC were compared with those in TLC and with ICHD-3 criteria. Cohen’s kappa (κ) and R² were used to assess diagnostic agreement. Results Among 1,468 patients (43.4 ± 14.4 years; 74.5% women), 69.5% reported a diagnosis in PSLC, and 99.5% were diagnosed at their first TLC visit. Overall agreement between PSLC and TLC was 80% (κ = 0.55; R²=30%). Agreement between the PSLC and ICHD-3 was 77% for migraine, 82% for TTH, and 96% for CH (κ = 0.65; R²=41%). TLC diagnoses aligned with ICHD-3 in over 90%. Conclusion Our findings indicate a significant degree of diagnostic agreement across different levels of care according to the ICHD-3 guidelines. However, there remains insufficient reliability in clinical diagnostics, highlighting the need for continued efforts to improve the early recognition and diagnostic accuracy and consistency of primary headaches to optimize patient care and treatment outcomes in Germany. |
| format | Article |
| id | doaj-art-8bb8f880f6cf4db99904ee14395ff1f5 |
| institution | Kabale University |
| issn | 1129-2377 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | The Journal of Headache and Pain |
| spelling | doaj-art-8bb8f880f6cf4db99904ee14395ff1f52025-01-12T12:33:11ZengBMCThe Journal of Headache and Pain1129-23772025-01-0126111210.1186/s10194-024-01937-6Consistency between headache diagnoses and ICHD-3 criteria across different levels of careLucas Hendrik Overeem0Marlene Ulrich1Mira Pauline Fitzek2Kristin Sophie Lange3Ja Bin Hong4Uwe Reuter5Bianca Raffaelli6Department of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinAbstract Background Diagnosing headache disorders poses significant challenges, particularly in primary and secondary levels of care (PSLC), potentially leading to misdiagnosis and underdiagnosis. This study evaluates diagnostic agreement for migraine, tension-type headache (TTH), and cluster headache (CH) between PSLC and tertiary care (TLC) and assesses adherence to the International Classification of Headache Disorders 3rd edition (ICHD-3) guidelines. Methods A retrospective, cross-sectional analysis was conducted at Charité - Universitätsmedizin Berlin’s tertiary headache center. The patients’ self-reported diagnoses from the PSLC were compared with those in TLC and with ICHD-3 criteria. Cohen’s kappa (κ) and R² were used to assess diagnostic agreement. Results Among 1,468 patients (43.4 ± 14.4 years; 74.5% women), 69.5% reported a diagnosis in PSLC, and 99.5% were diagnosed at their first TLC visit. Overall agreement between PSLC and TLC was 80% (κ = 0.55; R²=30%). Agreement between the PSLC and ICHD-3 was 77% for migraine, 82% for TTH, and 96% for CH (κ = 0.65; R²=41%). TLC diagnoses aligned with ICHD-3 in over 90%. Conclusion Our findings indicate a significant degree of diagnostic agreement across different levels of care according to the ICHD-3 guidelines. However, there remains insufficient reliability in clinical diagnostics, highlighting the need for continued efforts to improve the early recognition and diagnostic accuracy and consistency of primary headaches to optimize patient care and treatment outcomes in Germany.https://doi.org/10.1186/s10194-024-01937-6DiagnosesHeadacheICHD-3Levels of careLifting the burden |
| spellingShingle | Lucas Hendrik Overeem Marlene Ulrich Mira Pauline Fitzek Kristin Sophie Lange Ja Bin Hong Uwe Reuter Bianca Raffaelli Consistency between headache diagnoses and ICHD-3 criteria across different levels of care The Journal of Headache and Pain Diagnoses Headache ICHD-3 Levels of care Lifting the burden |
| title | Consistency between headache diagnoses and ICHD-3 criteria across different levels of care |
| title_full | Consistency between headache diagnoses and ICHD-3 criteria across different levels of care |
| title_fullStr | Consistency between headache diagnoses and ICHD-3 criteria across different levels of care |
| title_full_unstemmed | Consistency between headache diagnoses and ICHD-3 criteria across different levels of care |
| title_short | Consistency between headache diagnoses and ICHD-3 criteria across different levels of care |
| title_sort | consistency between headache diagnoses and ichd 3 criteria across different levels of care |
| topic | Diagnoses Headache ICHD-3 Levels of care Lifting the burden |
| url | https://doi.org/10.1186/s10194-024-01937-6 |
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