Stang P E, Yanagihara T, Swanson J W, Beard C M, Melton L J
Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minn.
Neuroepidemiology. 1991;10(5-6):297-307. doi: 10.1159/000110287.
Using the unique resources of the Rochester Epidemiology Project for population-based studies, we identified 629 Olmsted County, Minn., residents who fulfilled the 1988 International Headache Society criteria for newly diagnosed migraine over a 3-year period. Over 6,400 patient records from several diagnostic rubrics were screened; a substantial proportion of cases had been 'signed-out' to diagnoses other than 'migraine headache'. Medical records were reviewed by two trained nurses who abstracted supporting data for two neurologists. The neurologists determined whether each case met eligibility requirements and assigned a headache diagnosis by consensus. The diagnostic criteria offered some flexibility and were adapted to retrospective record-based research. Most records contained enough information to effectively classify the headache, although information on the frequency and duration of attacks proved to be problematic. A validation re-abstraction of a 10% sample of cases was undertaken with acceptable reproducibility of symptoms and diagnosis. Our study shows that migraine headache can be studied retrospectively through existing detailed medical records.
利用罗切斯特流行病学项目基于人群研究的独特资源，我们确定了明尼苏达州奥尔姆斯特德县的629名居民，他们在3年期间符合1988年国际头痛协会新诊断偏头痛的标准。我们筛查了来自多个诊断分类的6400多份患者记录；相当一部分病例被“转出”为“偏头痛性头痛”以外的诊断。两名经过培训的护士对病历进行了审查，她们为两名神经科医生提取了支持数据。神经科医生确定每个病例是否符合入选标准，并通过协商一致给出头痛诊断。诊断标准提供了一定的灵活性，并适用于基于回顾性记录的研究。大多数记录包含足够的信息来有效分类头痛，尽管发作频率和持续时间的信息被证明存在问题。我们对10%的病例样本进行了验证性重新提取，症状和诊断的可重复性可以接受。我们的研究表明，偏头痛可以通过现有的详细病历进行回顾性研究。
