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This study evaluates diagnostic agreement for migraine, tension-type headache (TTH), and cluster headache (CH) between PSLC and tertiary care (TLC) and assesses adherence to the International Classification of Headache Disorders 3rd edition (ICHD-3) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, cross-sectional analysis was conducted at Charit\u00e9 - Universit\u00e4tsmedizin Berlin\u2019s tertiary headache center. The patients\u2019 self-reported diagnoses from the PSLC were compared with those in TLC and with ICHD-3 criteria. Cohen\u2019s kappa (\u03ba) and R\u00b2 were used to assess diagnostic agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1,468 patients (43.4\u2009\u00b1\u200914.4 years; 74.5% women), 69.5% reported a diagnosis in PSLC, and 99.5% were diagnosed at their first TLC visit. Overall agreement between PSLC and TLC was 80% (\u03ba\u2009=\u20090.55; R\u00b2=30%). Agreement between the PSLC and ICHD-3 was 77% for migraine, 82% for TTH, and 96% for CH (\u03ba\u2009=\u20090.65; R\u00b2=41%). TLC diagnoses aligned with ICHD-3 in over 90%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings indicate a significant degree of diagnostic agreement across different levels of care according to the ICHD-3 guidelines. However, there remains insufficient reliability in clinical diagnostics, highlighting the need for continued efforts to improve the early recognition and diagnostic accuracy and consistency of primary headaches to optimize patient care and treatment outcomes in Germany.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s10194-024-01937-6","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T05:59:44Z","timestamp":1736402384000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Consistency between headache diagnoses and ICHD-3 criteria across different levels of care"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-7184","authenticated-orcid":false,"given":"Lucas Hendrik","family":"Overeem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Ulrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0299-4830","authenticated-orcid":false,"given":"Mira Pauline","family":"Fitzek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8056-8514","authenticated-orcid":false,"given":"Kristin Sophie","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1541-0291","authenticated-orcid":false,"given":"Ja Bin","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8527-0725","authenticated-orcid":false,"given":"Uwe","family":"Reuter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9758-1494","authenticated-orcid":false,"given":"Bianca","family":"Raffaelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"issue":"1","key":"1937_CR1","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s10194-022-01402-2","volume":"23","author":"LJ Stovner","year":"2022","unstructured":"Stovner LJ, Hagen K, Linde M, Steiner TJ (2022) The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. 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Due to the retrospective nature of this study, written informed consent from enrolled patients was not required under local regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"LHO has nothing to declare. MU has nothing to declare. MF reports personal fees from Novartis and Teva. JBH has nothing to declare. KSL reports personal fees from Teva and Acticor Biotech. UR reports personal fees from Amgen, Allergan, Abbvie, Lilly, Lundbeck, Novartis, electroCore, Medscape, StreaMedUp, and Teva, and research funding from Novartis. BR reports research grants from Novartis, Lundbeck, German Migraine and Headache Society (DMKG), German Research Foundation (DFG) and Else Kr\u00f6ner-Fresenius-Stiftung, and personal fees from Abbvie\/Allergan, Eli Lilly, Lundbeck, Novartis, Perfood and Teva.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"6"}}