Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
BMJ Open. 2021 Nov 30;11(11):e043242. doi: 10.1136/bmjopen-2020-043242.
Typically, migraine prevention trials focus on reducing migraine days. This narrow focus may not capture all that is important to people with migraine. Inconsistency in outcome selection across trials limits the potential for data pooling and evidence synthesis. In response, we describe the development of core outcome set for migraine (COSMIG).
A two-stage approach sought to achieve international, multistakeholder consensus on both the core domain set and core measurement set. Following construction of a comprehensive list of outcomes, expert panellists (patients, healthcare professionals and researchers) completed a three-round electronic-Delphi study to support a reduction and prioritisation of core domains and outcomes. Participants in a consensus meeting finalised the core domains and methods of assessment. All stages were overseen by an international core team, including patient research partners.
There was a good representation of patients (episodic migraine (n=34) and chronic migraine (n=42)) and healthcare professionals (n=33) with high response and retention rates. The initial list of domains and outcomes was reduced from >50 to 7 core domains for consideration in the consensus meeting, during which a 2-domain core outcome set was agreed.
International and multistakeholder consensus emerged to describe a two-domain core outcome set for reporting research on preventive interventions for chronic and episodic migraine: migraine-specific pain and migraine-specific quality of life. Intensity of migraine pain assessed with an 11-point Numerical Rating Scale and the frequency as the number of headache/migraine days over a specified time period. Migraine-specific quality of life assessed using the Migraine Functional Impact Questionnaire.
通常情况下,偏头痛预防试验侧重于减少偏头痛天数。这种狭隘的重点可能无法捕捉到偏头痛患者的所有重要内容。试验之间结果选择的不一致限制了数据汇总和证据综合的潜力。有鉴于此,我们描述了偏头痛核心结局集(COSMIG)的制定。
采用两阶段方法,旨在就核心领域集和核心测量集达成国际、多利益相关者共识。在构建了一个全面的结果清单之后,专家小组(患者、医疗保健专业人员和研究人员)完成了三轮电子德尔菲研究,以支持减少和优先考虑核心领域和结果。共识会议的参与者最终确定了核心领域和评估方法。所有阶段均由一个国际核心团队监督,包括患者研究合作伙伴。
偏头痛患者(发作性偏头痛(n=34)和慢性偏头痛(n=42))和医疗保健专业人员(n=33)的代表性很好,响应率和保留率都很高。最初的领域和结果清单从>50 项减少到 7 项核心领域,供共识会议审议,期间达成了 2 项核心结果集。
国际和多利益相关者达成共识,描述了用于报告慢性和发作性偏头痛预防干预研究的两项核心结果集:偏头痛特异性疼痛和偏头痛特异性生活质量。使用 11 点数字评分量表评估偏头痛疼痛强度,在指定时间段内头痛/偏头痛天数的频率作为数量。使用偏头痛功能影响问卷评估偏头痛特异性生活质量。