Table 2.
Changes in diagnoses in relation to the clinical evaluation setting
| DIAGNOSIS | TRIAGE nurse | ED doctor | Headache centre | Concordance TRIAGE - headache centre |
|---|---|---|---|---|
| (244 patients) | (244 patients) | (240 patients) | (κ; p - value) | |
| Headache | 155 (63.6) | 128 (52.5) | – | |
| Migraine without aura | 22 (9.0) | 82 (33.6) | 140 (57.4) | 0.581; p < 0.001 |
| Migraine with aura (ophthalmic headache) | 16 (6.6) | – | 34 (13.9) | 0.032; p = 0.586 |
| Tension-type headache | – | – | 32 (13.1) | – |
| Chronic migraine | – | – | 35 (14.3) | – |
| Medication overuse headache | – | – | 31 (12.7) | – |
| Cluster hedache | 2 (0.8) | 2 (0.8) | 7 (2.9) | −0.013; p = 0.001 |
| Other TACs | – | – | 1 (0.4) | – |
| Trigeminal neuralgia | 8 (3.3) | – | 3 (1.2) | – |
| Headache attributed to trauma | 5 (2.1) | 32 (13.1) | 8 (3.3) | – |
| Sinusitis | – | – | 2 (0.8) | – |
| Headache attributed to cranial and/or cervical vascular disorder | 16 (6.6) | – | 6 (2.5) | – |
| Headache and arterial hypertension | 10 (4.1) | – | 5 (2.0) | – |
| Headache and systemic infection | 6 (2.5) | – | 1 (0.4) | – |
| Headache and anxiety disorder | 3 (1.2) | – | – | – |
| Cervicogenic headache | 1 (0.4) | – | – | – |
TACs trigeminal autonomic cephalalgias
Triage nurses used the definition “ophthalmic headache” to indicate the diagnosis of “migraine with aura”
The concordance between primary headaches diagnosis was assessed using the Cohen Kappa coefficient (κ). The significance level was set at 0.05
There was not agreement between diagnoses made by ED physicians and headache centre