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In Reply We appreciate the thoughtful comments of Drs Evans and Sharma regarding headache neuroimaging in the United States. We agree that many paths exist to reduce inappropriate use of these expensive, low-yield tests and that the solution needs to be multifaceted. While we fully endorse creative approaches to reducing magnetic resonance imaging (MRI) costs when neuroimaging is medically necessary, we suspect that meaningful cost containment will not be possible without reducing guideline-discordant testing.
Callaghan BC, Kerber KA, Burke JF. Headaches and Neuroimaging—Reply. JAMA Intern Med. 2015;175(2):313-314. doi:10.1001/jamainternmed.2014.7014