title: Validation of a guideline-based decision support system for the diagnosis of primary headache disorders based on ICHD-3 beta.
abstract: BACKGROUND
  China may have the largest population of headache sufferers and therefore the most serious burden of disease worldwide. However, the rate of diagnosis for headache disorders is extremely low, possibly due to the relative complexity of headache subtypes and diagnostic criteria. The use of computerized clinical decision support systems (CDSS) seems to be a better choice to solve this problem.
  
  
  METHODS
  We developed a headache CDSS based on ICHD-3 beta and validated it in a prospective study that included 543 headache patients from the International Headache Center at the Chinese PLA General hospital, Beijing, China.
  
  
  RESULTS
  We found that the CDSS correctly recognized 159/160 (99.4%) of migraine without aura, 36/36 (100%) of migraine with aura, 20/21 (95.2%) of chronic migraine, and 37/59 (62.7%) of probable migraine. This system also correctly identified 157/180 (87.2%) of patients with tension-type headache (TTH), of which infrequent episodic TTH was diagnosed in 12/13 (92.3%), frequent episodic TTH was diagnosed in 99/101 (98.0%), chronic TTH in 18/20 (90.0%), and probable TTH in 28/46 (60.9%). The correct diagnostic rates of cluster headache and new daily persistent headache (NDPH) were 90.0% and 100%, respectively. In addition, the system recognized 32/32 (100%) of patients with medication overuse headache.
  
  
  CONCLUSIONS
  With high diagnostic accuracy for most of the primary and some types of secondary headaches, this system can be expected to help general practitioners at primary hospitals improve diagnostic accuracy and thereby reduce the burden of headache in China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Dong
authors.forename: Ziming
authors.initials: Z
authors.lastname: Yin
authors.forename: Mianwang
authors.initials: M
authors.lastname: He
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Chen
authors.affiliation: International Headache Center, Department of Neurology, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing 100853, China. xudonglu@bme.zju.edu.cn.
authors.forename: Xudong
authors.initials: X
authors.lastname: Lv
authors.forename: Shengyuan
authors.initials: S
authors.lastname: Yu
mesh_terms: D044466:Asian People / Q000208:ethnology; D002681:China / Q000208:ethnology; D002908:Chronic Disease; D020000:Decision Support Systems, Clinical / Q000592:standards*; D051270:Headache Disorders, Primary / Q000175:diagnosis* / Q000208:ethnology*; D006801:Humans; D038801:International Classification of Diseases / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies