title: Instrumental exams performance can be a contributing factor to the delay in diagnosis of migraine.
abstract: BACKGROUND
  Diagnostic delay is a recognized drawback for a correct management of migraine patients. The aim of this study was to investigate the possible relationship among number and type of examinations performed and diagnostic delay in migraine diagnosis.
  
  
  METHODS
  We enrolled 500 subjects referred to our Headache Center for a migraine without aura. We analyzed the relationship among diagnostic delay, number of examinations performed and performance of each single test by a Cox regression model and an ordinal logistic regression model.
  
  
  RESULTS
  Each individual exam increased a diagnostic delay of at least 12 months (p < 0.05, Cox regression model). Brain CT as the first diagnostic approach had a reduced risk of delay of more than 5 years (OR 0.632, 95% CI 0.71-0.56, p < 0.05, ordinal regression model).
  
  
  CONCLUSIONS
  The number of instrumental examinations seems to significantly influence the diagnostic delay. This aspect contributes to increase health care costs, the risk of pain chronicization and pharmacological treatment misuse.
authors.affiliation: Neurological Clinic, Marche Polytechnic University, Ospedali Riuniti, Ancona, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Viticchi
authors.forename: Marco
authors.initials: M
authors.lastname: Bartolini
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Falsetti
authors.forename: Jacopo
authors.initials: J
authors.lastname: Dolcini
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cerqua
authors.forename: Simona
authors.initials: S
authors.lastname: Luzzi
authors.forename: Leandro
authors.initials: L
authors.lastname: Provinciali
authors.forename: Mauro
authors.initials: M
authors.lastname: Silvestrini
mesh_terms: D000328:Adult; D057210:Delayed Diagnosis; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D008297:Male; D020326:Migraine without Aura / Q000175:diagnosis*; D016016:Proportional Hazards Models