[Variability in the treatment of headaches in visits to the Neuropaediatrics service at six Spanish hospitals].
BACKGROUND
Headache is one of the chief reasons for visiting Neuropaediatric units. Variability in clinical practice has been defined as variations in the rates a clinical procedure is employed. The aim of this work is to study the variability in the treatment of children's headaches in six Spanish hospitals.


METHODS
We conducted a retrospective study involving patients who first visited because of a headache some time in the year 1999. Data were collected in December 2003. The following variables were analysed: type of headache, neuroimaging scans, beginning of prophylaxis, follow-up visits to clinic and number of patients who dropped out of the follow-up.


RESULTS
In all, 372 children were attended. 63.4% of the headaches were considered as being migraine-type; 43% of the patients were submitted to neuroimaging and prophylaxis was established in 36.8%. Mean follow-up time in the clinic was 10.6 months and the mean number of visits was 3. 30% had dropped out of the follow-up. In the comparative analysis, significant differences were found in all the variables studied.


CONCLUSIONS
Overall results are similar to those found in other series. The differences found between centres can be accounted for by differences in population, differences in health professionals' styles of medical practice or by the nonexistence of clear guidelines regarding a particular procedure.
Servicio de Pediatría, Hospital Francesc de Borja de Gandia, Passeig de les Germanies 70, E-46700 Gandia, Valencia, Spain. tomas_mig@gva.es
M
M
Tomás-Vila
A
A
García-Perez
M A
MA
Martínez-Granero
M
M
Aleu Pérez-Gramunt
B
B
Martínez-Menéndez
F J
FJ
Martínez-Sarries
A
A
López-Lafuente
M
M
Benac-Prefaci
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006261:Headache / Q000145:classification / Q000628:therapy*; D006757:Hospital Units / Q000592:standards; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000592:standards; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D013030:Spain