Rationale for issuing neuroimaging requests for patients with primary headaches in China

作者全名：Zhong, X. M.; Zhao, L. C.; Peng, L. L.; Li, L.; Li, C. Q.

作者地址：[Zhong, X. M.; Zhao, L. C.; Peng, L. L.] Chengdu Second Peoples Hosp, Chengdu, Peoples R China; [Zhong, X. M.; Li, L.; Li, C. Q.] Chongqing Med Univ, Affiliated Hosp 2, Dept Neurol, Chongqing, Peoples R China; [Li, C. Q.] Chongqing Med Univ, Affiliated Hosp 2, 74 Linjiang Rd, Chongqing, Peoples R China

通信作者：Li, CQ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, 74 Linjiang Rd, Chongqing, Peoples R China.

来源：BRAIN AND BEHAVIOR

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:001239187500001

JCR分区：Q2

影响因子：2.6

年份：2024

卷号：14

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：decision-making; head computed tomography; head magnetic resonance imaging; neuroimaging; primary headache

摘要：ObjectiveTo investigate the prevalence of neuroimaging in patients with primary headaches and the clinician-based rationale for requesting neuroimaging in China.Data sources and study settingThis study included patients with primary headaches admitted to hospitals and clinicians in China. We identified whether neuroimaging was requested and the types of neuroimaging conducted.Study designThis was a cross-sectional study, and convenience sampling was used to recruit patients with primary headaches. Clinicians were interviewed using a combination of personal in-depth and topic-selection group interviews to explore why doctors requested neuroimaging.Data collection:We searched for the diagnosis of primary headache in the outpatient and inpatient systems according to the International Classification of Diseases-10 code of patients admitted to six hospitals in three provincial capitals by 2022.We selected three public and three private hospitals with neurology specialties that treated a corresponding number of patients.Principle findingsAmong the 2263 patients recruited for this study, 1942 (89.75%) underwent neuroimaging. Of the patients, 1157 (51.13%) underwent magnetic resonance imaging (MRI), 246 (10.87%) underwent both head computed tomography (CT) and MRI, and 628 (27.75%) underwent CT. Fifteen of the 16 interviewed clinicians did not issue a neuroimaging request for patients with primary headaches. Furthermore, we found that doctors issued a neuroimaging request for patients with primary headaches mostly, to exclude the risk of misdiagnosis, reduce uncertainty, avoid medical disputes, meet patients' medical needs, and complete hospital assessment indicators.ConclusionsFor primary headaches, the probability of clinicians requesting neuroimaging was higher in China than in other countries. There is considerable room for improvement in determining appropriate strategies to reduce the use of low-value care for doctors and patients. image

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