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Abstract：
OBJECTIVE: To investigate the prevalence of neuroimaging in patients with primary headaches and the clinician-based rationale for requesting neuroimaging in China.
METHODS: This study included patients with primary headaches admitted to hospitals and clinicians in China. We identified whether neuroimaging was requested and the types of neuroimaging conducted.
METHODS: This was a cross-sectional study, and convenience sampling was used to recruit patients with primary headaches. Clinicians were interviewed using a combination of personal in-depth and topic-selection group interviews to explore why doctors requested neuroimaging.
METHODS: We searched for the diagnosis of primary headache in the outpatient and inpatient systems according to the International Classification of Diseases-10 code of patients admitted to six hospitals in three provincial capitals by 2022.We selected three public and three private hospitals with neurology specialties that treated a corresponding number of patients.
RESULTS: Among the 2263 patients recruited for this study, 1942 (89.75%) underwent neuroimaging. Of the patients, 1157 (51.13%) underwent magnetic resonance imaging (MRI), 246 (10.87%) underwent both head computed tomography (CT) and MRI, and 628 (27.75%) underwent CT. Fifteen of the 16 interviewed clinicians did not issue a neuroimaging request for patients with primary headaches. Furthermore, we found that doctors issued a neuroimaging request for patients with primary headaches mostly, to exclude the risk of misdiagnosis, reduce uncertainty, avoid medical disputes, meet patients\' medical needs, and complete hospital assessment indicators.
CONCLUSIONS: For primary headaches, the probability of clinicians requesting neuroimaging was higher in China than in other countries. There is considerable room for improvement in determining appropriate strategies to reduce the use of low-value care for doctors and patients.
METHODS: This study included patients with primary headaches admitted to hospitals and clinicians in China. We identified whether neuroimaging was requested and the types of neuroimaging conducted.
METHODS: This was a cross-sectional study, and convenience sampling was used to recruit patients with primary headaches. Clinicians were interviewed using a combination of personal in-depth and topic-selection group interviews to explore why doctors requested neuroimaging.
METHODS: We searched for the diagnosis of primary headache in the outpatient and inpatient systems according to the International Classification of Diseases-10 code of patients admitted to six hospitals in three provincial capitals by 2022.We selected three public and three private hospitals with neurology specialties that treated a corresponding number of patients.
RESULTS: Among the 2263 patients recruited for this study, 1942 (89.75%) underwent neuroimaging. Of the patients, 1157 (51.13%) underwent magnetic resonance imaging (MRI), 246 (10.87%) underwent both head computed tomography (CT) and MRI, and 628 (27.75%) underwent CT. Fifteen of the 16 interviewed clinicians did not issue a neuroimaging request for patients with primary headaches. Furthermore, we found that doctors issued a neuroimaging request for patients with primary headaches mostly, to exclude the risk of misdiagnosis, reduce uncertainty, avoid medical disputes, meet patients\' medical needs, and complete hospital assessment indicators.
CONCLUSIONS: For primary headaches, the probability of clinicians requesting neuroimaging was higher in China than in other countries. There is considerable room for improvement in determining appropriate strategies to reduce the use of low-value care for doctors and patients.
摘要：
目的：调查原发性头痛患者神经影像学的患病率以及在中国要求神经影像学的临床依据。
方法：本研究纳入了中国医院和临床医生收治的原发性头痛患者。我们确定了是否需要神经影像学检查以及进行的神经影像学检查类型。
方法：这是一项横断面研究，方便抽样用于招募原发性头痛患者。结合个人深度访谈和主题选择小组访谈对临床医生进行了访谈，以探讨为什么医生要求神经影像学检查。
方法：我们根据国际疾病分类-10代码搜索了到2022年在三个省会城市的六家医院收治的患者的门诊和住院系统中原发性头痛的诊断。我们选择了三家公立医院和三家私立医院，这些医院都有神经内科专科，分别治疗了相应数量的患者。
结果：在本研究招募的2263名患者中，1942年（89.75％）接受了神经影像学检查。在患者中，1157（51.13%）接受了磁共振成像（MRI），246（10.87％）接受了头部计算机断层扫描（CT）和MRI，628例(27.75%)行CT检查。16位接受采访的临床医生中有15位没有对原发性头痛患者发出神经影像学检查要求。此外，我们发现医生对原发性头痛的患者发出神经影像学要求，为了排除误诊的风险，减少不确定性，避免医疗纠纷,满足患者的医疗需求，并完成医院考核指标。
结论：对于原发性头痛，在中国,临床医生要求神经影像学检查的概率高于其他国家.在确定适当的策略以减少对医生和患者使用低价值护理方面，还有相当大的改进空间。
方法：本研究纳入了中国医院和临床医生收治的原发性头痛患者。我们确定了是否需要神经影像学检查以及进行的神经影像学检查类型。
方法：这是一项横断面研究，方便抽样用于招募原发性头痛患者。结合个人深度访谈和主题选择小组访谈对临床医生进行了访谈，以探讨为什么医生要求神经影像学检查。
方法：我们根据国际疾病分类-10代码搜索了到2022年在三个省会城市的六家医院收治的患者的门诊和住院系统中原发性头痛的诊断。我们选择了三家公立医院和三家私立医院，这些医院都有神经内科专科，分别治疗了相应数量的患者。
结果：在本研究招募的2263名患者中，1942年（89.75％）接受了神经影像学检查。在患者中，1157（51.13%）接受了磁共振成像（MRI），246（10.87％）接受了头部计算机断层扫描（CT）和MRI，628例(27.75%)行CT检查。16位接受采访的临床医生中有15位没有对原发性头痛患者发出神经影像学检查要求。此外，我们发现医生对原发性头痛的患者发出神经影像学要求，为了排除误诊的风险，减少不确定性，避免医疗纠纷,满足患者的医疗需求，并完成医院考核指标。
结论：对于原发性头痛，在中国,临床医生要求神经影像学检查的概率高于其他国家.在确定适当的策略以减少对医生和患者使用低价值护理方面，还有相当大的改进空间。
