Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
Division of Brain Sciences, Imperial College London, London, UK.
J Headache Pain. 2018 Feb 2;19(1):12. doi: 10.1186/s10194-018-0837-3.
The burden attributable to headache disorders has multiple components: a simple measure summarising them all does not exist. The Migraine Disability Assessment (MIDAS) instrument has proved useful, estimating productive time lost in the preceding 3 months due to the disabling effect of headache. We developed adaptations of MIDAS for purposes of the Global Campaign against Headache, embracing epidemiological studies and the provision of clinical management aids.
We reviewed the structure, content, wording and scoring of MIDAS and made revisions, developing the Headache-Attributed Lost Time (HALT) Indices in three versions. Over 10 years, these were employed in multiple epidemiological and clinical studies in countries worldwide.
In the original HALT-90, we made no changes to the structure and scoring of MIDAS, but used wording in questions 1-4 that we believed would be more widely understood and more easily translated into other languages. Of the two alternative versions, HALT-30 kept the same structure, question format and wording except that "3 months" was replaced by "1 month". HALT-7/30 was a variant of HALT-30: focusing only on lost work time for population-based studies of headache-attributed burden, it enquired into lost days in the preceding month (30 days) and week (7 days).
Three versions of the HALT Indices serve different purposes as measures of headache-attributed burden, and offer different means of scoring. In studies using HALT as a population measure, there is no need to reflect the states of individuals, whereas a measure over shorter periods than 3 months is likely to be more reliable through better recall. Assessment of individual patients prior to treatment may best estimate impact if enquiry is made into the preceding 90 days, except in cases where headache is highly frequent. Follow-up in clinical management may be better served by assessments over 30 rather than 90 days.
头痛疾病的负担包括多个组成部分：目前还没有一个简单的指标可以对其进行全面总结。偏头痛残疾评估（MIDAS）工具已被证明非常有用，它可以评估过去 3 个月因头痛导致的致残而损失的生产性时间。我们为全球头痛防治运动（GAH）改编了 MIDAS，涵盖了流行病学研究和提供临床管理辅助工具。
我们回顾了 MIDAS 的结构、内容、措辞和评分，并进行了修订，开发了三种版本的头痛归因失时（HALT）指数。在过去 10 多年中，这些指数在全球范围内的多个国家的流行病学和临床研究中得到了应用。
在原始的 HALT-90 中，我们没有改变 MIDAS 的结构和评分，但在问题 1-4 中使用了我们认为更易于理解和更容易翻译成其他语言的措辞。在两种替代版本中，HALT-30 保留了相同的结构、问题格式和措辞，只是将“3 个月”替换为“1 个月”。HALT-7/30 是 HALT-30 的变体：它仅关注头痛负担人群研究中的失工时间，询问过去一个月（30 天）和一周（7 天）的缺勤天数。
HALT 指数的三种版本作为头痛负担的测量指标有不同的用途，并提供不同的评分方法。在使用 HALT 作为人群测量指标的研究中，无需反映个体的状态，而在 3 个月以下的较短时间段内进行测量，通过更好的回忆，可能会更可靠。在治疗前对个体患者进行评估，如果询问过去 90 天的情况，可能会更好地估计其影响，但在头痛发作非常频繁的情况下除外。在临床管理中，评估 30 天而不是 90 天可能更有助于随访。
