Impact of early headache neuroimaging on time to malignant brain tumor diagnosis: A retrospective cohort study

Carey, Matthew R.; Callaghan, Brian C.; Kerber, Kevin A.; Skolarus, Lesli E.; Burke, James F.

doi:10.1371/journal.pone.0211599

Cited by 4 publications

(2 citation statements)

References 28 publications

(22 reference statements)

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“…A study by Carey et al revealed the diagnosis of malignancy was rare in individuals presenting with incident headache and early neuroimaging (within 30 days of headache) led to a small reduction in time to diagnosis. 34 Interestingly, risk of death was higher in the early neuroimaging group compared to the referent group, and the authors postulate higher disease severity in this group. 34 Therefore, timing of neuroimaging did not change outcomes.…”

Section: Discussionmentioning

confidence: 95%

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The association between headache presentation, normal examination and neuroimaging findings: a retrospective analysis of patients presenting to a tertiary referral centre

Moodley¹,

Bhigjee²

2022

Afr H. Sci.

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Background: There is a high worldwide burden of headaches. Selection of patients with headaches for neuroimaging, in the absence of traditional red flags, is imperative in guiding further management. Objectives: Determine the yield of neuroimaging findings in patients with headache and normal examination; and potentially identifying additional red flags. Methods: A retrospective consecutive chart review of patients with a main complaint of headaches and normal clinical examination were assessed at a tertiary hospital, over a 10-year period. Results: Cohort consisted of 114 patients. Unexpected or normal variants found in 20.2% of patients (23/114) and 11.4% (13/114) required change in management. The absence of nausea and vomiting (p=0.009) and absence of sharp type headaches in unexpected or normal variants group (p=0.03) were statistically significant. There was a higher chance of an abnormal neuroimaging study in men and HIV seropositive patients. Conclusions: Decision to neuroimage should be determined on an individual basis (demographic factors, history of headache and examination) as normal examination cannot preclude patients from unexpected findings on neuroimaging. Headache with nausea and vomiting in isolation may be associated with normal neuroimaging reflecting primary type headaches. Findings support a lower threshold to neuroimage men and HIV seropositive patients with headaches despite normal clinical examination. Keywords: Headache; normal clinical examination; neuroimaging; headache red flags.

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Section: Discussionmentioning

confidence: 95%

“… 34 Interestingly, risk of death was higher in the early neuroimaging group compared to the referent group, and the authors postulate higher disease severity in this group. 34 Therefore, timing of neuroimaging did not change outcomes.…”

Section: Discussionmentioning

confidence: 95%

The association between headache presentation, normal examination and neuroimaging findings: a retrospective analysis of patients presenting to a tertiary referral centre

Moodley¹,

Bhigjee²

2022

Afr H. Sci.

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Neuroimaging for Pediatric Headache

Kadom

Forte

Horný

et al. 2022

Evidence-Based Imaging

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Healthcare spending versus mortality in central nervous system cancer: Has anything changed?

Guo,

Gupta,

Rossong

et al. 2024

Neuro-Oncology Practice

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Background The financial implications of central nervous system (CNS) cancers are substantial, not only for the healthcare service and payers, but also for the patients who bear the brunt of direct, indirect, and intangible costs. This study sought to investigate the impact of healthcare spending on CNS cancer survival using recent US data. Methods This study used public data from the Disease Expenditure Project 2016 and the Global Burden of Disease Study 2019. The primary outcome was the annual healthcare spending trend from 1996 and 2016 on CNS tumors adjusted for disease prevalence, alongside morbidity and mortality. Secondary outcomes included drivers of change in healthcare expenditures for CNS cancers. Subgroup analysis was performed stratified by age group, expenditure type, and care type provided. Results There was a significant increase in total healthcare spending on CNS cancers from $2.72 billion (95% CI, $2.47B to $2.97B) in 1996 to $6.85 billion (95% CI, $5.98B to $7.57B) in 2016. Despite the spending increase, mortality rate per 100,000 people did not change significantly, with 5.30 ± 0.47 in 1996 and 7.02 ± 0.47 in 2016, with an average of 5.78 ± 0.47 deaths per 100,000 over the period. The subgroups with the highest expenditure included patients aged 45 to 64, those with private insurance, and those receiving inpatient care. Conclusions This study highlights a significant rise in healthcare costs for CNS cancers without corresponding improvements in mortality rate, indicating a mismatch of healthcare spending, contemporary advances, and patient outcome as it relates to mortality.

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Impact of early headache neuroimaging on time to malignant brain tumor diagnosis: A retrospective cohort study

Cited by 4 publications

References 28 publications

The association between headache presentation, normal examination and neuroimaging findings: a retrospective analysis of patients presenting to a tertiary referral centre

The association between headache presentation, normal examination and neuroimaging findings: a retrospective analysis of patients presenting to a tertiary referral centre

Neuroimaging for Pediatric Headache

Healthcare spending versus mortality in central nervous system cancer: Has anything changed?

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