Computer-aided diagnoses of chronic head pain: explanation, study data, implications, and challenges

The differential diagnosis of diseases and disorders having head pain as a symptom is often a difficult challenge for health care professionals. The complexity of this problem, the need for computer aided diagnosis, and the assumptions upon which one diagnostic software program was developed are discussed. A database driven user-oriented Internet website was offered at no charge to headache sufferers, and this vehicle provided the data source for research. The software program compares consistent user surveys to 253 expert profiles compiled from searches of the best available material in the medical/dental literature. A database of 1288 consistent user surveys was studied and analyzed for this paper. Findings discussed are: 1. the large amount of users (63%) who do not match any expert profile to a reasonable degree of medical certainty; 2. the significance of the relatively large amount of headache sufferers (17%) whose diagnosis or diagnoses are solely within the realm of dentistry; and 3. the importance of differentiating between discriminating and substantiating diagnostic criteria. Many users do not fit existing algorithms for chronic head pain. Data generated by this computer-aided diagnostic software program challenge some current paradigms and concepts of diagnosis. The data generated question "correct to a reasonable degree of medical certainty," challenge "a preponderance of the evidence" as scientific diagnostic standards, and also question whether rendering a working diagnosis is possible on each and every patient.