Landmark: Patient and Physician Diagnoses
{"Image DocumentName": "Landmark: Patient and Physician Diagnoses", "Image ImageDescription": "In a prospective, open-label study of 1203 patients with episodic headache. Patient. If patient self-reports migraine, 99.5% chance migraine or probable migraine. If patient self-reports non-migraine, 86% chance migraine or probable migraine. Physician. If physician diagnoses migraine, 98% chance migraine or probable migraine. If physician diagnoses non-migraine, 82% chance migraine or probable migraine. Of the 206 patients in the Landmark study who self-reported migraine at the screening visit, almost all (99.5%) were confirmed as having migraine or probable migraine by the expert panel (88% migraine, 11.5% probable migraine). No patient who self-reported migraine was subsequently diagnosed with episodic tension-type headache. Of the 272 patients who were given a new diagnosis of migraine by their physician, 98% were diagnosed with migraine or probable migraine by the expert panel. Therefore, a patient or a physician diagnosis of migraine is likely to be accurate, according to this study. However, if the patient or the physician diagnosed non-migraine, there was a high probability that the patient actually had migraine. Of the 148 patients who self-reported non-migraine headache, 86% were diagnosed by the expert panel with migraine or probable migraine. Likewise, of the 105 patients diagnosed by their physicians as having non-migraine headache, 82% were assigned a diagnosis of migraine or probable migraine by the expert panel. A self-report or physician diagnosis of migraine was almost always correct. On the other hand, a self-report or physician diagnosis of non-migraine was almost always later found out to be migraine. It may be helpful to provide such tools as migraine diaries for patients, and request them to fill it out over several migraine attacks before asking the patient to return to the clinic. During this followup visit, the physician can review the diary and refer to the I.H.S. diagnostic criteria in order to help reach a final diagnosis. Self-report or physician diagnosis of migraine was almost always correct. Self-report or physician diagnosis of non-migraine was almost always later found out to be migraine. Adapted from Tepper SJ et al. Headache. 2004;44:856\u2013864.", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}