Study finds high utilisation of neuroimaging for headaches despite guidelines


A recent study has found that neuroimaging for headaches is frequently ordered by physicians during outpatient visits, despite guidelines that recommend against such routine procedures.

The study was published in JAMA Internal Medicine. The authors, Brian C Callaghan of the University of Michigan Health System, Ann Arbor, USA and colleagues, analysed National Ambulatory Medical Care Survey data for all headache visits for patients 18 years or older from 2007 through 2010.


They found that there were 51.1 million headache visits during those four years, including 25.4 million for migraines. Neuroimaging was performed in 12.4% of all headache visits and in 9.8% of migraine visits at an estimated cost of US$3.9 billion. The use of neuroimaging has increased from 5.1% of all annual headache visits in 1995 to 14.7% in 2010.


The authors conclude, “Since 2000, multiple guidelines have recommended against routine neuroimaging in patients with headaches because a serious intracranial pathologic condition is an uncommon cause. Consequently, the magnitude of per-visit neuroimaging use found in this study suggests considerable overuse.”