CPGPrompt/merged_decision_tree_atypical.json at main · bionlplab/CPGPrompt · GitHub

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{
  "nodes": [
    {
      "name": "Thunderclap headache",
      "yes_action": "Send to emergency department for immediate CT to exclude subarachnoid hemorrhage",
      "no_node": "Headache with fever and neck stiffness",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Headache with fever and neck stiffness",
      "yes_action": "Send immediately to emergency department for CT and lumbar puncture",
      "no_node": "Papilledema with altered consciousness and/or focal signs",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Papilledema with altered consciousness and/or focal signs",
      "yes_action": "Send immediately to emergency department with neuroimaging for investigation",
      "no_node": "Acute angle-closure glaucoma",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Acute angle-closure glaucoma",
      "yes_action": "Send immediately for ophthalmological assessment or emergency department",
      "no_node": "Signs of systemic illness with new-onset headache",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Signs of systemic illness with new-onset headache",
      "yes_action": "Require urgent specialist consultation and/or investigation",
      "no_node": "New headache in patients over 50 with symptoms of temporal arteritis",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "New headache in patients over 50 with symptoms of temporal arteritis",
      "yes_action": "Urgent investigation and possible temporal artery biopsy required",
      "no_node": "Papilledema in alert patient without focal neurological signs",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Papilledema in alert patient without focal neurological signs",
      "yes_action": "Urgent specialist referral and neuroimaging required",
      "no_node": "Elderly patient with new headache and subacute cognitive change",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Elderly patient with new headache and subacute cognitive change",
      "yes_action": "Urgent specialist referral and/or neuroimaging required",
      "no_node": "Check for Cervicogenic Headache",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Cervicogenic Headache",
      "yes_action": "Consider Cervicogenic Headache",
      "no_node": "Check for Post Traumatic Headache",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Post Traumatic Headache",
      "yes_action": "Diagnose Post Traumatic Headache",
      "no_node": "Check for Temporomandibular Disorder",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Temporomandibular Disorder",
      "yes_action": "Consider Temporomandibular Disorder",
      "no_node": "Check for Atypical Headaches or Changes in Pattern (Patients with headaches that do not fit the typical pattern of migraine or tension-type headache, and patients with a major change in headache pattern.)",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Atypical Headaches or Changes in Pattern (Patients with headaches that do not fit the typical pattern of migraine or tension-type headache, and patients with a major change in headache pattern.)",
      "yes_action": "Consider Specialist Consultation and/or Neuroimaging",
      "no_node": "Check for Unexplained Focal Signs",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Unexplained Focal Signs",
      "yes_action": "Require Specialist Referral and/or Neuroimaging",
      "no_node": "Check for Unusual Headache Precipitants",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Unusual Headache Precipitants",
      "yes_action": "Consider Specialist Referral and/or Brain MRI Scan",
      "no_node": "Check for Unusual Aura Symptoms",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Unusual Aura Symptoms",
      "yes_action": "Refer to Neurologist",
      "no_node": "Check for Cluster Headache and Other Uncommon Syndromes",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Cluster Headache and Other Uncommon Syndromes",
      "yes_action": "Consider Specialist Referral for Investigation and Treatment",
      "no_node": "Check for Late Onset Headache",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Late Onset Headache",
      "yes_action": "Consider Neuroimaging and/or Blood Tests",
      "no_node": "Check for Persistent Headache Attributed to Head Trauma",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Check for Persistent Headache Attributed to Head Trauma",
      "yes_action": "Consider Specialist Referral on Case by Case Basis",
      "no_node": "Diagnose Migraine Without Aura",
      "criteria": null,
      "min_criteria": null
    },
    {
      "name": "Diagnose Migraine Without Aura",
      "yes_action": "Refer to Section 2: Management of Migraine Headache",
      "no_node": "Check Episodic Tension-Type Headache",
      "criteria": [
        "nausea during the attack",
        "light sensitivity during the attack",
        "some attacks interfere with activities"
      ],
      "min_criteria": 2
    },
    {
      "name": "Check Episodic Tension-Type Headache",
      "yes_action": "Refer to Section 3: Management of Tension-Type Headache",
      "no_node": "Check Cluster Headache or Trigeminal Autonomic Cephalalgia",
      "criteria": [
        "bilateral headache",
        "non-pulsating pain",
        "mild to moderate intensity",
        "headache not worsened by activity"
      ],
      "min_criteria": 2
    },
    {
      "name": "Check Cluster Headache or Trigeminal Autonomic Cephalalgia",
      "yes_action": "Refer to Section 5: Management of Cluster Headache; Neurologist referral recommended",
      "no_node": "Check Hemicranias Continua",
      "criteria": [
        "frequent",
        "severe",
        "brief (duration of less than 3 hours)",
        "unilateral",
        "ipsilateral conjunctival injection and/or tearing and/or restlessness during the attacks"
      ],
      "min_criteria": 5
    },
    {
      "name": "Check Hemicranias Continua",
      "yes_action": "Refer to Section 6: Other Headache Disorders: Neurologist referral recommended",
      "no_node": "Check New Daily Persistent Headache",
      "criteria": [
        "strictly unilateral",
        "always on the same side of the head",
        "responds dramatically to indomethacin"
      ],
      "min_criteria": 3
    },
    {
      "name": "Check New Daily Persistent Headache",
      "yes_action": "Consider secondary headaches; Neurologist referral recommended",
      "no_node": "End of Decision Tree",
      "criteria": null,
      "min_criteria": null
    }
  ]
}