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印度头痛障碍负担:在卡纳塔克邦进行基于社区的调查的方法和问卷验证。

The burden of headache disorders in India: methodology and questionnaire validation for a community-based survey in Karnataka State.

机构信息

Department of Epidemiology, National Institute of Mental Health and NeuroSciences, Bangalore, 560-029, India.

出版信息

J Headache Pain. 2012 Oct;13(7):543-50. doi: 10.1007/s10194-012-0474-1. Epub 2012 Aug 22.

Abstract

Primary headache disorders are a major public-health problem globally and, possibly more so, in low- and middle-income countries. No methodologically sound studies of prevalence and burden of headache in the adult Indian population have been published previously. The present study was a door-to-door cold-calling survey in urban and rural areas in and around Bangalore, Karnataka State. From 2,714 households contacted, 2,514 biologically unrelated individuals were eligible for the survey and 2,329 (92.9 %) participated (1,103 [48 %] rural; 1,226 [52 %] urban; 1,141 [49 %] male; 1,188 [51 %] female; mean age 38.0 years). The focus was on primary headache (migraine and tension-type headache [TTH]) and medication-overuse headache. A structured questionnaire administered by trained lay interviewers was the instrument both for diagnosis (algorithmically determined from responses) and burden estimation. The screening question enquired into headache in the last year. The validation study compared questionnaire-based diagnoses with those obtained soon after through personal interview by a neurologist in a random sub-sample of participants (n = 381; 16 %). It showed high values (> 80 %) for sensitivity, specificity and predictive values for any headache, and for specificity and negative predictive value for migraine and TTH. Kappa values for diagnostic agreement were good for any headache (0.69 [95 % CI 0.61-0.76]), moderate (0.46 [0.35-0.56]) for migraine and fair (0.39 [0.29-0.49]) for TTH. The survey methodology, including identification of and access to participants, proved feasible. The questionnaire proved effective in the survey population. The study will give reliable estimates of the prevalence and burden of headache, and of migraine and TTH specifically, in urban and rural Karnataka.

摘要

原发性头痛疾患是全球,尤其是中低收入国家的一个主要公共卫生问题。此前,尚未发表过关于印度成年人群头痛患病率和负担的方法可靠研究。本研究是在卡纳塔克邦班加罗尔及其周边城乡地区进行的逐户冷呼叫调查。在联系的 2714 户家庭中,有 2514 户生物学上无关联的个体符合调查条件,其中 2329 户(92.9%)参与了调查(1103 户[48%]为农村;1226 户[52%]为城市;1141 户[49%]为男性;1188 户[51%]为女性;平均年龄 38.0 岁)。研究重点是原发性头痛(偏头痛和紧张型头痛[TTH])和药物过度使用性头痛。由经过培训的非专业调查员使用结构化问卷进行调查,该问卷既是用于诊断(根据应答情况采用算法确定),也是用于负担评估。调查问卷采用的筛查问题询问了参与者过去一年中的头痛情况。验证研究将问卷调查得出的诊断结果与随后由神经科医生在随机参与者子样本(n=381;16%)中进行个人访谈获得的诊断结果进行了比较。结果显示,任何头痛、偏头痛和 TTH 的诊断灵敏度、特异度和预测值均高于 80%,特异性和阴性预测值也较高。任何头痛的诊断一致性kappa 值良好(0.69[95%CI 0.61-0.76]),偏头痛和 TTH 的kappa 值为中度(0.46[0.35-0.56])和一般(0.39[0.29-0.49])。调查方法(包括参与者的识别和接触)切实可行,调查问卷在调查人群中也具有有效性。该研究将为卡纳塔克邦城乡地区头痛、偏头痛和 TTH 的患病率和负担提供可靠的估计。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb7f/3444540/212823092daa/10194_2012_474_Fig1_HTML.jpg

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