Department of Neurology, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing 100853, China.
J Headache Pain. 2011 Apr;12(2):141-6. doi: 10.1007/s10194-011-0336-2. Epub 2011 Mar 31.
The objective of this study was to test the validity, in the Chinese population, of the Lifting The Burden diagnostic questionnaire for the purpose of a population-based survey of the burden of headache in China. From all regions of China, a population-based sample of 417 respondents had completed the structured questionnaire in a door-to-door survey conducted by neurologists from local hospitals calling unannounced. They were contacted for re-interview by telephone by headache specialists who were unaware of the questionnaire diagnoses. A screening question ascertained whether headache had occurred in the last year. If they had, the specialists applied their expertise and ICHD-II diagnostic criteria to make independent diagnoses which, as the gold standard, were later compared with the questionnaire diagnoses. There were 18 refusals; 399 interviews were conducted in 202 women and 197 men aged 18-65 years (mean age 44.4±12.6 years). In comparison to the specialists' diagnoses, the sensitivity, specificity, positive predictive value, negative predictive value and Cohen's kappa (95% CI) of the questionnaire for the diagnosis of migraine were 0.83, 0.99, 0.83, 0.99 and 0.82 (0.71-0.93), respectively; for the diagnosis of tension-type headache (TTH), they were 0.51, 0.99, 0.86, 0.92 and 0.59 (0.46-0.72), respectively. In conclusion, the questionnaire was accurate and reliable in diagnosing migraine (agreement level excellent), less so, but adequate, for TTH (sensitivity relatively low, false negative rate relatively high and agreement level fair to good). The non-specific features of TTH do not lend themselves well to diagnosis by questionnaire.
本研究旨在检验 Lifting The Burden 诊断问卷在中国人群中的有效性，以便在中国开展基于人群的头痛负担调查。从中国各地，通过当地医院的神经科医生进行的上门调查，共招募了 417 名符合条件的受访者，完成了结构化问卷。这些受访者通过头痛专家进行了电话重访，这些头痛专家并不知道问卷的诊断结果。一个筛选问题确定了他们在过去一年中是否发生过头痛。如果有，专家们会运用他们的专业知识和 ICHD-II 诊断标准进行独立诊断，这些诊断作为金标准，随后与问卷诊断进行比较。有 18 人拒绝参与；共进行了 399 次访谈，其中包括 202 名女性和 197 名年龄在 18-65 岁之间的男性（平均年龄为 44.4±12.6 岁）。与专家诊断相比，问卷诊断偏头痛的敏感性、特异性、阳性预测值、阴性预测值和 Cohen's kappa（95%CI）分别为 0.83、0.99、0.83、0.99 和 0.82（0.71-0.93）；对于紧张型头痛（TTH）的诊断，它们分别为 0.51、0.99、0.86、0.92 和 0.59（0.46-0.72）。总之，该问卷在诊断偏头痛方面准确可靠（一致性水平极好），在诊断 TTH 方面虽然准确性稍差，但仍足够（敏感性相对较低，假阴性率相对较高，一致性水平为中等至良好）。TTH 的非特异性特征不利于通过问卷进行诊断。
