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Kaiser EA, Igdalova A, Aguirre GK, Cucchiara B. A web-based, branching logic questionnaire for the automated classification of migraine. Cephalalgia 2019; 39:1257-1266. [PMID: 31042063 DOI: 10.1177/0333102419847749] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify migraineurs and headache-free individuals with an online questionnaire and automated analysis algorithm. METHODS We created a branching-logic, web-based questionnaire - the Penn Online Evaluation of Migraine - to obtain standardized headache history from a previously studied cohort. Responses were analyzed with an automated algorithm to assign subjects to one of several categories based on ICHD-3 (beta) criteria. Following a pre-registered protocol, the primary outcome was sensitivity and specificity for assignment of headache-free, migraine without aura, and migraine with aura labels, as compared to a prior classification by neurologist interview. RESULTS Of 118 subjects contacted, 90 (76%) completed the questionnaire; of these 31 were headache-free controls, 29 migraine without aura, and 30 migraine with aura. Mean age was 41 ± 6 years and 76% were female. There were no significant demographic differences between groups. The median time to complete the questionnaire was 2.5 minutes (IQR: 1.5-3.4 minutes). Sensitivity of the Penn Online Evaluation of Migraine tool was 42%, 59%, 70%, and 83%, and specificity was 100%, 84%, 93%, and 90% for headache-free controls, migraine without aura, migraine with aura, and migraine overall, respectively. CONCLUSIONS The Penn Online Evaluation of Migraine web-based questionnaire, and associated analysis routine, identifies headache-free and migraine subjects with good specificity. It may be useful for classifying subjects for large-scale research studies. Research study pre-registration: https://osf.io/sq9ef The following research study is a not a clinical trial.
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Affiliation(s)
- Eric A Kaiser
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Geoffrey K Aguirre
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Brett Cucchiara
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
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Lampl C, Thomas H, Tassorelli C, Katsarava Z, Laínez JM, Lantéri-Minet M, Rastenyte D, Ruiz de la Torre E, Stovner LJ, Andrée C, Steiner TJ. Headache, depression and anxiety: associations in the Eurolight project. J Headache Pain 2016; 17:59. [PMID: 27245683 PMCID: PMC4887397 DOI: 10.1186/s10194-016-0649-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Headache disorders and psychiatric disorders are both common, while evidence, mostly pertaining to migraine, suggests they are comorbid more often than might be expected by chance. There are good reasons for establishing whether they are: symptoms of comorbid illnesses may summate synergistically; comorbidities hinder management, negatively influencing outcomes; high-level comorbidity indicates that, where one disease occurs, the other should be looked for. The Eurolight project gathered population-based data on these disorders from 6624 participants. METHODS Eurolight was a cross-sectional survey sampling from the adult populations (18-65 years) of 10 EU countries. We used data from six. The questionnaire included headache-diagnostic questions based on ICHD-II, the Headache-Attributed Lost Time (HALT) questionnaire, and HADS for depression and anxiety. We estimated odds ratios (ORs) to show associations between migraine, tension-type headache (TTH) or probable medication-overuse headache (pMOH) and depression or anxiety. RESULTS pMOH was most strongly associated with both psychiatric disorders: for depression, ORs (vs no headache) were 5.5 [2.2-13.5] (p < 0.0001) in males, 5.5 [2.9-10.5] (p < 0.0001) in females; for anxiety, ORs were 10.4 [4.9-21.8] (p < 0.0001) and 7.1 [4.5-11.2] (p < 0.0001). Migraine was also associated with both: for depression, ORs were 2.1 [1.3-3.4] (p = 0.002) and 1.8 [1.1-3.1] (p = 0.030); for anxiety 4.2 [2.8-6.3] (p < 0.0001) and 2.4 [1.7-3.4] (p < 0.0001). TTH showed associations only with anxiety: ORs 2.5 [1.7-3.7] (p < 0.0001) for males, 1.5 [1.1-2.1] (p = 0.021) for females. Participants with migraine carried 19.1 % probability of comorbid anxiety, 6.9 % of depression and 5.1 % of both, higher than the representative general-population sample (14.3, 5.6 and 3.8 %). Probabilities in those with MOH were 38.8, 16.9 and 14.4 %; in TTH, they did not exceed those of the whole sample. Comorbid psychiatric disorder did not add to headache-attributed productive time losses, but weak associations existed (R (2) = 0.020-0.082) for all headache types between lost productive time and probabilities of depression and, less so, anxiety. CONCLUSION In this large study we confirmed that depression and especially anxiety are comorbid more than by chance with migraine, and showed the same is true, but more strongly, with MOH. Arguably, migraine patients and, more certainly, MOH patients should be screened with HADS in pursuit of best outcomes.
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Affiliation(s)
- Christian Lampl
- Headache Medical Center, Linz, Austria
- Department of Neurogeriatric Medicine and Remobilisation, Hospital of the Sisters of Charity, Linz, Austria
| | - Hallie Thomas
- Department of Neuroscience, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway
| | - Cristina Tassorelli
- Headache Science Centre, C Mondino National Neurological Institute, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Zaza Katsarava
- Department of Neurology, University of Duisberg-Essen, Essen, Germany
- Department of Neurology, Evangelical Hospital Unna, Unna, Germany
| | - Jose Miguel Laínez
- Department of Neurology, Hospital Clinico Universitario, University of Valencia, Valencia, Spain
| | - Michel Lantéri-Minet
- Departement d'Evaluation et Traitement de la Douleur, Centre Hospitalo-Universitaire de Nice, Nice, France
- INSERM/UdA, U1107, Neuro-Dol, Clermont-Ferrand, France
| | | | | | - Lars Jacob Stovner
- Department of Neuroscience, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway
- Norwegian Advisory Unit on Headache, St Olavs University Hospital, Trondheim, Norway
| | - Colette Andrée
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Timothy J Steiner
- Department of Neuroscience, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway.
- Division of Brain Sciences, Imperial College London, London, UK.
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Short-term diagnostic stability of probable headache disorders based on the International Classification of Headache Disorders, 3rd edition beta version, in first-visit patients: a multicenter follow-up study. J Headache Pain 2016; 17:13. [PMID: 26892842 PMCID: PMC4759261 DOI: 10.1186/s10194-016-0605-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/12/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A "Probable headache disorder" is diagnosed when a patient's headache fulfills all but one criterion of a headache disorder in the 3rd beta edition of the International Classification of Headache Disorder (ICHD-3β). We investigated diagnostic changes in probable headache disorders in first-visit patients after at least 3 months of follow-up. METHODS This was a longitudinal study using a prospective headache registry from nine headache clinics of referral hospitals. The diagnostic change of probable headache disorders at baseline was assessed at least 3 months after the initial visit using ICHD-3β. RESULTS Of 216 patients with probable headache disorders at baseline, the initial probable diagnosis remained unchanged for 162 (75.0 %) patients, while it progressed to a definite diagnosis within the same headache subtype for 45 (20.8 %) by fulfilling the criteria during a median follow-up period of 6.5 months. Significant difference on the proportions of constant diagnosis was not found between headache subtypes (P < 0.935): 75.9 % for probable migraine, 73.7 % for probable tension-type headache (TTH), and 76.0 % for probable other primary headache disorders (OPHD). Among patients with headache recurrence, the proportion of constant diagnosis was higher for probable migraine than for probable TTH plus probable OPHD (59.2 vs. 23.1 %; P < 0.001). The proportions of constant diagnosis did not significantly differ by follow-up duration (>3 and ≤ 6 months vs. > 6 and ≤ 10 months) in probable migraine, probable TTH, and probable OPHD, respectively. CONCLUSIONS In this study, a probable headache diagnosis, based on ICHD-3β, remained in approximately three-quarters of the outpatients; however, diagnostic stability could differ by headache recurrence and subtype. Probable headache management might have to consider these differences.
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Lampl C, Thomas H, Stovner LJ, Tassorelli C, Katsarava Z, Laínez JM, Lantéri-Minet M, Rastenyte D, Ruiz de la Torre E, Andrée C, Steiner TJ. Interictal burden attributable to episodic headache: findings from the Eurolight project. J Headache Pain 2016; 17:9. [PMID: 26879832 PMCID: PMC4754227 DOI: 10.1186/s10194-016-0599-8] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/02/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Most primary headaches are episodic, and most estimates of the heavy disability burden attributed to headache derive from epidemiological data focused on the episodic subtypes of migraine and tension-type headache (TTH). These disorders give rise directly but intermittently to symptom burden. Nevertheless, people with these disorders may not be symptom-free between attacks. We analysed the Eurolight dataset for interictal burden. METHODS Eurolight was a cross-sectional survey using modified cluster sampling from the adult population (18-65 years) in 10 countries of the European Union. We used data from nine. The questionnaire included headache-diagnostic questions based on ICHD-II and several question sets addressing impact, including interictal and cumulative burdens. RESULTS There were 6455 participants with headache (male 2444 [37.9 %]). Interictal symptoms were reported by 26.0 % of those with migraine and 18.9 % with TTH: interictal anxiety by 10.6 % with migraine and avoidance (lifestyle compromise) by 14.8 %, both much more common than in TTH (3.1 % [OR 3.8] and 4.7 % [OR 3.5] respectively). Mean time spent in the interictal state was 317 days/year for migraine, 331 days/year for TTH. Those who were "rarely" or "never" in control of their headaches (migraine 15.2 %, TTH 9.6 %) had significantly raised odds of interictal anxiety, avoidance and other interictal symptoms. Among those with migraine, interictal anxiety increased markedly with headache intensity and frequency, avoidance less so but still significantly. Lost productive time was associated with high ORs (up to 5.3) of anxiety and avoidance. A third (32.9 %) with migraine and a quarter (26.7 %) with TTH (difference: p < 0.0001) were reluctant to tell others of their headaches. About 10 % with each disorder felt families and friends did not understand their headaches. Nearly 12 % with migraine reported their employers and colleagues did not. Regarding cumulative burden, 11.8 % reported they had done less well in education because of headache, 5.9 % reported reduced earnings and 7.4 % that their careers had suffered. CONCLUSIONS Interictal burden in those with episodic headache is common, more so in migraine than TTH. Some elements have the potential to be profoundly consequential. New methodology is needed to measure interictal burden if descriptions of headache burden are to be complete.
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Affiliation(s)
- Christian Lampl
- Headache Medical Center, Linz, Austria
- Department of Neurogeriatric Medicine and Remobilisation, Hospital of the Sisters of Charity, Linz, Austria
| | - Hallie Thomas
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Jacob Stovner
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headache, St Olavs University Hospital, Trondheim, Norway
| | - Cristina Tassorelli
- Headache Science Centre, C Mondino National Neurological Institute, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Zaza Katsarava
- Department of Neurology, University of Duisberg-Essen, Essen, Germany
- Department of Neurology, Evangelical Hospital Unna, Unna, Germany
| | - Jose Miguel Laínez
- Department of Neurology, Hospital Clinico Universitario, University of Valencia, Valencia, Spain
| | - Michel Lantéri-Minet
- Departement d'Evaluation et Traitement de la Douleur, Centre Hospitalo-Universitaire de Nice, Nice, France
- INSERM/UdA, U1107, Neuro-Dol, Clermont-Ferrand, France
| | | | | | - Colette Andrée
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Timothy J Steiner
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
- Division of Brain Sciences, Imperial College London, London, UK.
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Kim SK, Moon HS, Cha MJ, Kim BS, Kim BK, Park JW, Park KY, Sohn JH, Chu MK, Song TJ, Kim JM, Cho SJ. Prevalence and Features of a Probable Diagnosis in First-Visit Headache Patients Based on the Criteria of the Third Beta Edition of the International Classification of Headache Disorders: A Prospective, Cross-Sectional Multicenter Study. Headache 2016; 56:267-75. [PMID: 26832954 DOI: 10.1111/head.12742] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 08/23/2015] [Accepted: 08/23/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVES This study aimed to determine the characteristics and significance of a probable diagnostic entity for primary headache disorder (PHD). BACKGROUND A diagnosis of probable primary headache disorder (PPHD) is given when a patient's headache fulfills all but one criteria of the third beta edition of the international classification of headache disorder (ICHD-3β). Despite the uncertainty regarding this diagnosis, the inclusion of a probable diagnosis entity in this manual may aid in the accurate classification of headache disorders and allow effective treatment strategies to be started at the patient's initial visit. METHODS This cross-sectional multicenter registry study assessed first-visit patients with complaints of headaches who presented at the outpatient clinics of 11 neurologists in Korea. The classification of a headache disorder was made according to the criteria of the ICHD-3β by each investigator based on the initial evaluation of the patient or by a consensus meeting for uncertain cases. The rates of a probable diagnosis among PPHD patients were assessed and the clinical characteristics of these patients were compared with those of patients with a diagnosis of definite primary headache disorder (DPHD). RESULTS A total of 1429 patients were diagnosed with PHD, and 305 (21.3%) of these patients had PPHD. The proportions of PPHD differed among the subtypes of DPHD as follows: migraines (16.1%), tension-type headaches (TTH; 33%), trigeminal autonomic cephalalgia (TAC; 40.9%), and other PHD (14%, P < .001). Patients with PPHD had less severe headache intensity than patients with DPHD (5.8 ± 2.2 vs. 6.5 ± 2.1, respectively, P < .001) as well as a shorter duration of headache from onset (median: 1 vs. 4 months, respectively, P < .001). The most common criteria missing for a definite diagnosis in the PPHD patients were total frequency (52.1%), duration of attack (14.4%), and accompanying symptoms (13.1%). CONCLUSIONS A probable diagnosis was given to 21.3% of the first-visit PHD patients due to incomplete or atypical presentations of the headaches. The incorporation of a probable diagnosis into the ICHD-3β may be useful for reducing the diagnoses of unspecified headaches.
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Affiliation(s)
- Soo-Kyoung Kim
- Department of Neurology, Gyeongsang National University Hospital, Jinju, Korea
| | - Heui-Soo Moon
- Department of Neurology, Kangbuk Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myong-Jin Cha
- Department of Neurology, National Police Hospital, Seoul, Korea
| | - Byung-Su Kim
- Department of Neurology, Bundan Jesaeng Hospital, Seongnam, Korea
| | - Byung-Kun Kim
- Neurology, Eulji University School of Medicine, Seoul, Korea
| | - Jeong-Wook Park
- Department of Neurology, Uijeongbu St.Mary's Hospital the Catholic University of Korea, Uijeongbu, Korea
| | - Kwang-Yeol Park
- Department of Neurology, Chung-Ang University Hospital Chung-Ang University College of Medicine, Seoul, Korea
| | - Jong-Hee Sohn
- Department of Neurology, Chuncheon Sacred Heart Hospital Hallym University College of Medicine, Chuncheon, Korea
| | - Min-Kyung Chu
- Department of Neurology, Hallym University Sacred Heart Hospital Hallym University College of Medicine, Anyang, Korea
| | - Tae-Jin Song
- Department of Neurology, Ewha Womans University, Seoul, Korea
| | - Jae-Moon Kim
- Department of Neurology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hopital, Hallym University College of Medicine, Hwaseong, Korea
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Valença MM, de Oliveira DA. The Frequent Unusual Headache Syndromes: A Proposed Classification Based on Lifetime Prevalence. Headache 2015; 56:141-52. [PMID: 26335933 DOI: 10.1111/head.12646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND There is no agreement on a single cutoff point or prevalence for regarding a given disease as rare. The concept of what is a rare headache disorder is even less clear and the spectrum from a very frequent, frequent, occasional to rare headache syndrome is yet to be established. OBJECTIVE An attempt has been made to estimate the lifetime prevalence of each of the headache subtypes classified in the ICHD-II. METHOD Using the ICHD-II, 199 different headache subtypes were identified. The following classification was made according to the estimated lifetime prevalence of each headache disorder: very frequent (prevalence >10%); frequent (between 1 and 10%); occasional (between 0.07 and 1%); and unusual or rare (<0.07%). RESULTS One hundred and fifty-four of 199 (77%) were categorized as unusual headache disorders, 7/199 (4%) as very frequent, 9/199 (5%) as frequent, and 29/199 (15%) as occasional forms of headache disorder. CONCLUSION The unusual headache syndromes do not appear to be as infrequent in clinical practice as has been generally believed. About three-fourths of the classified headache disorders found in the ICHD-II can be considered as rare. This narrative review article may be regarded as an introduction to the concept of unusual headaches and a proposed classification of all headaches (at least those listed in the ICHD-II).
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Affiliation(s)
- Marcelo M Valença
- Department of Neuropsychiatry, Neurology and Neurosurgery Unit, Federal University of Pernambuco, Brazil.,Neurology and Neurosurgery Unit, Hospital Esperança, Brazil
| | - Daniella A de Oliveira
- Department of Neuropsychiatry, Neurology and Neurosurgery Unit, Federal University of Pernambuco, Brazil
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Steiner TJ, Stovner LJ, Katsarava Z, Lainez JM, Lampl C, Lantéri-Minet M, Rastenyte D, Ruiz de la Torre E, Tassorelli C, Barré J, Andrée C. The impact of headache in Europe: principal results of the Eurolight project. J Headache Pain 2014; 15:31. [PMID: 24884549 PMCID: PMC4045992 DOI: 10.1186/1129-2377-15-31] [Citation(s) in RCA: 217] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 05/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND European data, at least from Western Europe, are relatively good on migraine prevalence but less sound for tension-type headache (TTH) and medication-overuse headache (MOH). Evidence on impact of headache disorders is very limited. Eurolight was a data-gathering exercise primarily to inform health policy in the European Union (EU). This manuscript reports personal impact. METHODS The study was cross-sectional with modified cluster sampling. Surveys were conducted by structured questionnaire, including diagnostic questions based on ICHD-II and various measures of impact, and are reported from Austria, France, Germany, Italy, Lithuania, Luxembourg, Netherlands, Spain and United Kingdom. Different methods of sampling were used in each. The full methodology is described elsewhere. RESULTS Questionnaires were analysed from 8,271 participants (58% female, mean age 43.4 y). Participation-rates, where calculable, varied from 10.6% to 58.8%. Moderate interest-bias was detected. Unadjusted lifetime prevalence of any headache was 91.3%. Gender-adjusted 1-year prevalences were: any headache 78.6%; migraine 35.3%; TTH 38.2%, headache on ≥15 d/mo 7.2%; probable MOH 3.1%. Personal impact was high, and included ictal symptom burden, interictal burden, cumulative burden and impact on others (partners and children). There was a general gradient of probable MOH > migraine > TTH, and most measures indicated higher impact among females. Lost useful time was substantial: 17.7% of males and 28.0% of females with migraine lost >10% of days; 44.7% of males and 53.7% of females with probable MOH lost >20%. CONCLUSIONS The common headache disorders have very high personal impact in the EU, with important implications for health policy.
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Affiliation(s)
- Timothy J Steiner
- Department of Neuroscience, Norwegian University of Science and Technology, Edvard Griegs Gate, NO-7491 Trondheim, Norway
- Division of Brain Sciences, Imperial College London, London, UK
| | - Lars Jacob Stovner
- Department of Neuroscience, Norwegian University of Science and Technology, Edvard Griegs Gate, NO-7491 Trondheim, Norway
- Norwegian National Headache Centre, St Olavs University Hospital, Trondheim, Norway
| | - Zaza Katsarava
- Department of Neurology, University of Essen, Essen, Germany
| | - Jose Miguel Lainez
- Department of Neurology, Hospital Clinico Universitario, University of Valencia, Valencia, Spain
| | - Christian Lampl
- Headache Medical Center Seilerstaette Linz, Department of Neurogeriatric Medicine and Remobilisation, Hospital of the Sisters of Charity, Linz Seilerstaette 4, 4010 Linz, Austria
| | - Michel Lantéri-Minet
- Departement d’Evaluation et Traitement de la Douleur, Centre Hospitalo-Universitaire de Nice, Nice, France
| | | | | | - Cristina Tassorelli
- Headache Science Centre, C Mondino National Neurological Institute and Department of Brain and Behaviour, University of Pavia, Pavia, Italy
| | - Jessica Barré
- Center of Public Health Research, CRP-Santé, Strassen, Luxembourg
| | - Colette Andrée
- Center of Public Health Research, CRP-Santé, Strassen, Luxembourg
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
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Stovner LJ, Al Jumah M, Birbeck GL, Gururaj G, Jensen R, Katsarava Z, Queiroz LP, Scher AI, Tekle-Haimanot R, Wang SJ, Steiner TJ. The methodology of population surveys of headache prevalence, burden and cost: principles and recommendations from the Global Campaign against Headache. J Headache Pain 2014; 15:5. [PMID: 24467862 PMCID: PMC3907133 DOI: 10.1186/1129-2377-15-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 01/02/2014] [Indexed: 11/10/2022] Open
Abstract
The global burden of headache is very large, but knowledge of it is far from complete and needs still to be gathered. Published population-based studies have used variable methodology, which has influenced findings and made comparisons difficult. Among the initiatives of the Global Campaign against Headache to improve and standardize methods in use for cross-sectional studies, the most important is the production of consensus-based methodological guidelines. This report describes the development of detailed principles and recommendations. For this purpose we brought together an expert consensus group to include experience and competence in headache epidemiology and/or epidemiology in general and drawn from all six WHO world regions. The recommendations presented are for anyone, of whatever background, with interests in designing, performing, understanding or assessing studies that measure or describe the burden of headache in populations. While aimed principally at researchers whose main interests are in the field of headache, they should also be useful, at least in parts, to those who are expert in public health or epidemiology and wish to extend their interest into the field of headache disorders. Most of all, these recommendations seek to encourage collaborations between specialists in headache disorders and epidemiologists. The focus is on migraine, tension-type headache and medication-overuse headache, but they are not intended to be exclusive to these. The burdens arising from secondary headaches are, in the majority of cases, more correctly attributed to the underlying disorders. Nevertheless, the principles outlined here are relevant for epidemiological studies on secondary headaches, provided that adequate definitions can be not only given but also applied in questionnaires or other survey instruments.
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Affiliation(s)
- Lars Jacob Stovner
- Norwegian National Headache Centre, Norwegian University of Science and Technology, and St. Olavs University Hospital, Trondheim, Norway
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mohammed Al Jumah
- King Abdullah International Medical Research Center, King Saud Ben Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia
- Prince Mohammed Ben Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Gretchen L Birbeck
- Department of Neurology, University of Rochester, Rochester, NY, USA
- Chikankata Hospital, Mazabuka, Zambia
| | - Gopalakrishna Gururaj
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Rigmor Jensen
- Danish Headache Centre, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Zaza Katsarava
- Evangelical Hospital, Unna, Germany
- University of Duisburg-Essen, Essen, Germany
| | - Luiz Paulo Queiroz
- Department of Neurology, University Hospital, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Ann I Scher
- Uniformed Services University, Bethesda, MD, USA
| | - Redda Tekle-Haimanot
- School of Medicine, Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Shuu-Jiun Wang
- The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Neurology, Brain Research Center and Institute of Brain Science, National Yang-Ming University of School of Medicine, Taipei, Taiwan
| | - Timothy J Steiner
- Norwegian National Headache Centre, Norwegian University of Science and Technology, and St. Olavs University Hospital, Trondheim, Norway
- Division of Neuroscience, Imperial College London, London, UK
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