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Clinicians Increasingly Ordering Imaging for Headaches

From 1999-2000 to 2009-2010, increases seen in use of CT/MRI, referrals to other physicians

MONDAY, Jan. 12, 2015 (HealthDay News) — Clinicians are increasingly ordering advanced imaging and referring to other physicians for headache but less often providing counseling, according to a study published online Jan. 8 in the Journal of General Internal Medicine.

John N. Mafi, M.D., from Harvard Medical School in Boston, and colleagues characterized trends from 1999 through 2010 in management of headache. Data were collected from a nationally representative sample of visits to clinicians for headache from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medicare Care Survey.

During the study period, the researchers identified 9,362 visits for headache, representing approximately 144 million visits. Almost three-quarters of patients were female, with a mean age of about 46 years. From 1999-2000 to 2009-2010, there was an increase in use of computed tomography/magnetic resonance imaging from 6.7 to 13.9 percent of visits and an increase in referrals to other physicians from 6.9 to 13.2 percent. Clinician counseling decreased from 23.5 to 18.5 percent. Preventive medication use increased from 8.5 to 15.9 percent, while there was no change in opioid/barbiturate use (about 18 percent). Trends were similar after adjustment and after stratification of headaches as migraine versus nonmigraine and acute versus chronic presentation.

“The management of headache represents an important opportunity to improve the value of U.S. health care,” the authors write.

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