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Green Flags and headache: A concept study using the Delphi method.

Heiko Pohl¹, Thien Phu Do², David García-Azorín³

¹Department of Neurology, University Hospital Zurich, Zurich, Switzerland.

|January 6, 2021

Summary

This summary is machine-generated.

This study identified five Green Flags to help distinguish primary headaches from secondary ones. These flags can improve diagnostic accuracy and resource allocation in clinical practice.

Keywords:

diagnostic error diagnostic uncertainty primary headache red flags secondary headache

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Area of Science:

Neurology
Clinical Diagnostics

Background:

Differentiating primary and secondary headaches is crucial for accurate diagnosis.
Identifying specific signs and symptoms is key to correct headache assessment.

Purpose of the Study:

To collect and rate "Green Flags" indicating a higher likelihood of primary headache.
To establish consensus on key indicators for primary headache disorders.

Main Methods:

A Delphi study methodology was employed.
An expert panel proposed and anonymously rated potential Green Flags over two rounds.
Consensus was reached on flags with an average rating of 4.0 or higher (0-5 scale).

Main Results:

Five Green Flags achieved consensus for primary headache disorders.
These include headache history from childhood, cyclical occurrence with menstruation, headache-free days, familial headache patterns, and clear temporal onset/offset (>1 week).

Conclusions:

Five Green Flags are proposed to aid in primary headache diagnosis.
While not pathognomonic, Green Flags, alongside Red Flags, can enhance diagnostic accuracy.
Clinical application may improve diagnostic resource allocation; prospective validation is recommended.