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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.
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.
