Diagnostic and classification tools for chronic headache disorders: A systematic review.

Area of Science:

• Neurology
• Primary Care Medicine
• Diagnostic Tool Development

Background:

• Chronic headache diagnosis is challenging for non-expert clinicians despite existing guidelines.
• The International Classification of Headache Disorders (ICHD-III beta) criteria exist but are difficult to apply in primary care settings.

Purpose of the Study:

• To identify headache classification tools suitable for non-expert clinicians in primary care.
• To assess the usability of existing tools for diagnosing common chronic headache disorders.

Main Methods:

• A systematic literature review was conducted from January 1988 to June 2016.
• Key databases searched included MEDLINE, ASSIA, Embase, Web of Knowledge, and PsycINFO.
• Quality assessment of diagnostic accuracy studies used the QUADAS-2 criteria.

Main Results:

• 38 papers validated 30 different headache diagnostic or classification tools.
• Nine tools were for multiple headache types, and 21 were for single headache types.
• No tool was identified that is validated for primary care use by non-experts to classify common chronic headaches, excluding migraine and tension-type headache.

Conclusions:

• Many headache classification tools exist, but a gap remains for primary care.
• A need exists for a tool to aid primary care clinicians in diagnosing and managing chronic headaches.
• Such a tool could facilitate more targeted referrals to headache specialists.