[Study of the diagnostic agreement on headaches between neurology and primary care].
BACKGROUND
Headache as a symptom is a very common disease and one of the main reasons for consultation in primary care.


OBJECTIVE
To analyze the characteristics of patients referred from primary care to general neurology whose chief complaint was headache and/or neuralgia and diagnostic agreement.


METHODS
Cross-sectional study of all patients referred from primary care; demographic/clinical variables were collected and diagnostic hypothesis by primary care and general neurology were compared by determining their agreement.


RESULTS
2,514 were referred from primary care patients (588 of them on a preferential basis); in 378 cases the reason for consultation was headache and/or neuralgia (average 42.46 years; 77.8% female). In 139 patients it was established only a semiological diagnostic and other episodic migraine predominated (49.79%), chronic tension headache (18.41%) and trigeminal neuralgia (12.13%). Since general neurology, the most common diagnoses were, respectively, 33.86%, 24.05% and 18.67%. A compatible kappa coefficient of 0.543 (p < 0.05) with a moderate agreement when considering only those patients referred from primary care to a specific diagnosis was obtained.


CONCLUSIONS
Headaches are a very common reason for consultation in primary care (15%). The diagnostic agreement is moderate in our health sector so it is necessary to design training programs to help outline the criteria for referral to specialists and improve care for our patients.
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
S
S
Santos-Lasaosa
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
P R
PR
Vinueza-Buitron
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
A
A
Velazquez-Benito
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
C
C
Iniguez-Martinez
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
P
P
Larrode-Pellicer
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
L J
LJ
Lopez Del Val
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
J A
JA
Mauri-Llerda
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
S
S
Sanchez-Valiente
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
J L
JL
Millan-Morales
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008881:Migraine Disorders; D009437:Neuralgia / Q000175:diagnosis*; D009462:Neurology; D011320:Primary Health Care; D012017:Referral and Consultation