Clinical Experience as a Factor in the Inconsistencies of Migraine Care: Anne-Maree Kelly, MD

The director of the Joseph Epstein Center for Emergency Medicine Research discussed whether years of experience causes variation in the way migraine is diagnosed and treated in an emergency department setting. [WATCH TIME: 2 minutes]

WATCH TIME: 2 minutes

"Our study is about raising those questions and saying, ‘We accept that we can do better. How can we go forward?’ I think that’s an issue and goes again to the need of pathways or processes to support people who are only there for a short period of time."

In an international, multicenter study, investigators found several different inconsistencies with how emergency departments (ED) handled the investigation, diagnosis, and treatment of patients who present with nontraumatic headache. Most notably, there was wide variation in the use of neuroimaging, mainly CT scans, and the therapies used to treat these patients. Nontraumatic migraine was also shown to be difficult to diagnose, with more than 30 different diagnoses made across a cohort of 4536 patients.

While the study expanded on the epidemiology of nontraumatic headache, it did not include the experience levels of those working in EDs to treat these patients. While the decisions of clinicians are primarily science-based, it may be possible that years of seniority could play a factor into the care of patients, according to lead author Anne-Maree Kelly, MD.

Kelly, director, Joseph Epstein Center for Emergency Department Research, sat down with NeurologyLive® and commented on how much clinical experience changes the way a patient with nontraumatic headache may be treated as well as other reasons for the wide variation observed.