Diagnostic peer-agreement
Diagnostic peer-agreement by disease area is reported in Figure 1. All
four consultants agreed on diagnosis in 99/200 cases. Three consultants
agreed in 56/200 cases and two in 39/200 cases. There were 6 cases of
complete disagreement: a case of ill-defined widespread sensory-motor
disturbance (diagnoses of enhanced physiological
tremor/cramp-fasciculation syndrome, uncertain, possible cervical spinal
pathology and health anxiety were offered); an atypical blackout
(diagnoses: uncertain, transient ischemic attack, focal seizure, fugue
state); a case of non-specific dizziness (uncertain/exclude multiple
sclerosis, possible cerebellar ischemic inflammatory/neoplastic
pathology, possible vestibular dysequilibrium, functional disorder); and
three headache disorders: (1: atypical migraine, stress-related
headache, atypical cluster headache, tension headache; 2: chronic
pain/neurological cause unlikely, uncertain, mastoiditis, somatisation
disorder; 3: idiopathic stabbing headache; primary headache; tension
headache; migraine).