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ACR Appropriateness Criteria® Headache: 2022 Update.

, Pallavi S Utukuri¹, Robert Y Shih²

¹Columbia University Medical Center, New York, New York.

Journal of the American College of Radiology : JACR

|May 26, 2023

Summary

This document provides imaging guidelines for headache diagnosis. It clarifies appropriate imaging for various headache types, from acute to chronic, to aid clinical decision-making.

Keywords:

AUC Appropriate Use Criteria Appropriateness Criteria autonomic cephalalgias headache headache in pregnancy intracranial hypertension intracranial hypotension primary trigeminal thunderclap

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Published on: July 29, 2021

Area of Science:

Neurology
Radiology
Clinical Guidelines

Background:

Headache disorders are a leading cause of global disability, incurring significant economic costs.
The wide range of headache etiologies necessitates clear diagnostic pathways.
This work addresses the need for standardized initial imaging recommendations for diverse headache presentations.

Framework:

Presents evidence-based guidelines for eight distinct clinical headache scenarios.
Utilizes the American College of Radiology Appropriateness Criteria framework.
Incorporates systematic literature analysis and expert consensus methodologies.

Implementation:

Guidelines are developed through annual review by a multidisciplinary expert panel.
Methodologies like Grading of Recommendations Assessment, Development, and Evaluation (GRADE) are adapted.
The RAND/UCLA Appropriateness Method guides the determination of imaging procedure suitability.

Implications:

Aims to optimize the initial diagnostic imaging approach for patients with headaches.
Supports clinicians in selecting the most appropriate imaging tests based on clinical presentation.
Enhances the effective management of headache disorders through evidence-based recommendations.