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Study Summary
Only a small number of patients who come to the emergency room with a headache have a serious cause. This study aimed to compare the proportion of patients with specific red flag criteria between those diagnosed with a serious secondary headache and those without it.
Methods
- Secondary analysis of data from the HEAD and HEAD-Colombia studies
- Investigated 10 red flag criteria individually and in combination
Results
- 5293 patients included, with 6.1% having a serious cause identified
- Identified predictors of serious secondary headache diagnosis: new neurological deficit, history of neoplasm, older age, and recent head trauma
- Some criteria like sudden onset, onset during exertion, pregnancy, and immune suppression were not associated with a serious headache diagnosis
- Red flag criteria had a sensitivity of 96.5% but low specificity of 5.1%
Conclusion
The study found that while red flag criteria can help identify patients at higher risk of a serious secondary headache cause, they may also lead to increased rates of CT scanning due to their low specificity.
Practical Implications: Red flag criteria can be useful for identifying patients at higher risk of serious secondary headaches, but their low specificity may lead to more CT scans being performed.
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