Neuroimaging Commonly Ordered for Headache Evaluation, Despite Recommendations Against It — Physician’s First Watch
Neuroimaging Commonly Ordered for Headache Evaluation, Despite Recommendations Against It
By Amy Orciari Herman
Neuroimaging is ordered in roughly 10% of office visits for headache in the U.S. — and the price tag is steep, at nearly $1 billion per year — according to a research letter in JAMA Internal Medicine. Guidelines, however, recommend against routine imaging for headache complaints.
Using administrative data, researchers evaluated over 50 million visits for headache to primary care clinicians or specialists from 2007 through 2010. Either MRI or CT was ordered in 12% of all headache visits and in 10% of migraine visits. The estimated cost was $3.9 billion across the 4 years.
In an accompanying commentary, one of the journal's editors reminds clinicians "that the cost[s] we should care most about... are the unnecessary radiation ... and incidental findings that lead to unnecessary medical procedures and great anxiety on the part of our patients." He stresses the importance of "educating our patients about headaches and the dangers of neuroimaging."