Interrater agreement in headache diagnoses

Author:

Neumeier Maria Susanne1ORCID,Stattmann Miranda1,Wegener Susanne1,Gantenbein Andreas R12,Pohl Heiko1ORCID

Affiliation:

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

2. Department of Neurology, Zurzach Care, Bad Zurzach, Switzerland

Abstract

Background: Diagnosing headache disorders comprises the collection and interpretation of information. This study estimates agreement and bias in the latter. Methods: Physicians and medical students diagnosed eight patients’ headaches using the International Classification of Headache Disorders. We calculated Cohen’s Kappa for all participants and subgroups (board-certified neurologists, physicians working in a neurology department). Moreover, we asked how sure they felt about their diagnoses. Finally, participants estimated the number of different headache diagnoses a patient receives when consulting many physicians for the same headache and indicated the highest acceptable number. Results: The data of 63 participants entered the analysis, of whom 18 were neurologists (18/63, 28.6%), and 41 were currently working at a neurology clinic (41/63, 66.7%). Cohen’s Kappa decreased (0.706, 0.566, and 0.408) with increasing levels of the classification hierarchy. Interrater agreement was highest among neurologists. Physicians not working in a neurology clinic tended to diagnose secondary headaches more often were less confident about their diagnoses. Conclusions: Physicians with less experience in headache disorders struggle more to diagnose headaches than neurologists do; they suspect secondary headaches, disagree, and feel insecure more often. Thus, interpreting a headache history is prone to error and bias.

Funder

Werner Dessauer Stiftung

Publisher

SAGE Publications

Subject

Neurology (clinical)

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Artificial intelligence and headache;Cephalalgia;2024-08

2. Approaching Headaches—A Guide to Differential-Diagnostic Considerations and Causal Claims;Clinical and Translational Neuroscience;2023-07-18

3. Screening for Cluster Headache—Introduction of the SMARTED Scale;Clinical and Translational Neuroscience;2022-12-21

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