Table 1 Data extracted from case report/series and clinical/population studies dealing with diagnostic/therapeutic errors in CH
Authors | N. of pts | Sample | Methods of data acquisition | Diagnostic delay (means) | Misdiagnoses | Treatment before diagnosis of CH | Number/ type of physicians consulted prior to correct diagnosis | Wrong treatment after correct diagnosis |
|---|---|---|---|---|---|---|---|---|
Van Alboom et al., 2009 [6] | 85 | Clinic-based series | 90-item questionnaire | 44.4 mths | Migraine (45%), sinusitis (23%), tooth/jaw problems (23%), TTH (16%), TN (16%), ophthalmological problems (10%), neck problems (7%), nose problems (5%) | 31% of pts had invasive therapy prior to CH diagnosis, including dental procedures (21%) and sinus surgery (10%) | ≥3 (in 52% pts) | Propranolol (12%), amitriptyline (9%), carbamazepine (12%) |
Eross et al. 2007 [11] | 1 | General population study (SAMS) | Direct interview | NR | Sinus headache | NR | self-diagnosed | NR |
Jensen et al. 2007 [26] | 85 | Clinic-based series§ | Semistructured telephone interview | 8 yrs (range 0–35) for ECH and 9 yrs (range 0–39) for CCH | NR | Non-medical treatment was received by 58% (49/85) of the cluster patients | NR. 44.7% (38/85) of the CH pts had previously been admitted to hospital due to CH | NR |
Schurks et al. 2006 [17] | 246 | Clinic- and non-clinic- based | Direct interview (telephone or face-to-face) or standardized mailed questionnaire | NR | NR | NR | NR | 25% of patients used non-first-choice medication (such as opioids) |
Bahra and Goadsby 2004 [8] | 230 | Non-clinic-based (76%) and clinic-based (24%) | Direct interview (telephone or face- to-face) | 2.6Â yrs (1990s) to 22.3Â yrs (1960s) | NR | 52% of pts who had been seen by a dentist or ENT surgeon had an invasive procedure | Mean 3 GPs. 2/3 of the pts seen by another specialist: dentist (45%), ENT (27%), optician (43%), opht (15%), others (7%) | Beta-blocker (43%), pizotifen (32%), TCAs (32%); alternative therapy (including acupuncture in 40%, herbal treatment in 31%, chiropractic treatment in 23%, homeopathy in 18%) |
Van Vliet et al. 2003 [18] | 1163 | Nationwide study clinic- and non-clinic- based population | Questionnaire | 3 yrs (range 1 wk–48 yrs) | Sinusitis (21%), migraine (17%), dental-related pain (11%) | Tooth extraction (16%) and ENT operation (12%) | Dentists (34%), ENT specialists (33%), and alternative therapists (33%) | NR |
Sjastaad & Bakketeig, 2003 [19] | 7 | General population study (Vågå study) on headache epidemiology | Direct interview plus physical and neurological examination | 11 yrs (range <1 – 28) | NR (5 out of 7 pts had never consulted a physician) | NR (5 out of 7 pts had never consulted a physician) | 5 out of 7 pts had never consulted a physician | NR |
Klapper et al. 2000 [13] | 693 | Internet-based survey | Internet questionnaire | 6.6Â yrs | 3.9 (average number of incorrect diagnoses before CH) NOS | 5% had surgery (mostly sinus or deviated septum surgery), other pts were prescribed with sinus medications | 4.3 (3.3 gave an incorrect diagnosis) | Propranolol (27.2%) amitriptyline (16.4%), cyproheptadine (2.3%) |
Hoffert 1995 [12] | 1 | Case report | Case report | 5Â yrs | Dental pain | Extractions of all the teeth | Dentist | NR |
Bittar and Graff-Radford 1992 [9] | 33 | Clinic-based series | Review of clinical chart | 8Â yrs (mean duration of pain) | NR | 42% of pts received inappropriate dental treatment which was often irreversible, almost all pts received different medications (NSAIDs, opiates, AEDs, TCAs) | Consultant seen before: 72% neurologist, 42% dentist, 27% internist, 12% ENT, 9% allergist | NR |