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Headache and Neuroimaging: Why We Continue to Do It

Headache and Neuroimaging: Why We Continue to Do It REVIEW ARTICLE J.E. Jordan and A.E. Flanders ABSTRACT SUMMARY: The appropriate imaging of patients with headache presents a number of important and vexing challenges for clini- cians. Despite a number of guidelines and studies demonstrating a lack of cost-effectiveness, clinicians continue to image patients with chronic nonfocal headaches, and the trend toward imaging is increasing. The reasons are complex and include the fear of missing a clinically significant lesion and litigation, habitual and standard of care practices, lack of tort reform, regulatory penalties and potential impact on one’s professional reputation, patient pressures, and financial motivation. Regulatory and legislative reforms are needed to encourage best practices without fear of professional sanctions when following the guidelines. The value of negative findings on imaging tests requires better understanding because they appear to provide some measure of societal value. Clinical decision support tools and machine intelligence may offer additional guidance and improve quality and cost-efficient man- agement of this challenging patient population. ABBREVIATIONS: AI ¼ artificial intelligence; CDS ¼ clinical decision support; ED ¼ emergency department EPIDEMIOLOGY cupping if bloodletting from the arm or forehead did not relieve ppropriate imaging for patients presenting with headache headache symptoms. Acontinues to be a ubiquitous challenge http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Headache and Neuroimaging: Why We Continue to Do It

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References (52)

Publisher
American Journal of Neuroradiology
Copyright
© 2020 by American Journal of Neuroradiology
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A6591
Publisher site
See Article on Publisher Site

Abstract

REVIEW ARTICLE J.E. Jordan and A.E. Flanders ABSTRACT SUMMARY: The appropriate imaging of patients with headache presents a number of important and vexing challenges for clini- cians. Despite a number of guidelines and studies demonstrating a lack of cost-effectiveness, clinicians continue to image patients with chronic nonfocal headaches, and the trend toward imaging is increasing. The reasons are complex and include the fear of missing a clinically significant lesion and litigation, habitual and standard of care practices, lack of tort reform, regulatory penalties and potential impact on one’s professional reputation, patient pressures, and financial motivation. Regulatory and legislative reforms are needed to encourage best practices without fear of professional sanctions when following the guidelines. The value of negative findings on imaging tests requires better understanding because they appear to provide some measure of societal value. Clinical decision support tools and machine intelligence may offer additional guidance and improve quality and cost-efficient man- agement of this challenging patient population. ABBREVIATIONS: AI ¼ artificial intelligence; CDS ¼ clinical decision support; ED ¼ emergency department EPIDEMIOLOGY cupping if bloodletting from the arm or forehead did not relieve ppropriate imaging for patients presenting with headache headache symptoms. Acontinues to be a ubiquitous challenge

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Jul 1, 2020

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