医生和医学专业最后一年学生中的偏头痛：对来自巴基斯坦的患病率、自我认知及知识的横断面洞察。
Migraine in physicians and final year medical students: A cross-sectional insight into prevalence, self-awareness, and knowledge from Pakistan.
作者信息
Choudry Hassan, Ata Fateen, Naveed Alam Muhammad Naveed, Ruqaiya Ruqaiya, Suheb Mahammed Khan, Ikram Muhammad Qaiser, Chouhdry Muhammad Muzammil, Muaz Muaz
机构信息
Department of Respiratory Medicine, University Hospital of Leicester, Leicester LE1, United Kingdom.
Department of Internal Medicine, Hamad Medical Corporation, Doha 0000, Qatar.
出版信息
World J Methodol. 2022 Sep 20;12(5):414-427. doi: 10.5662/wjm.v12.i5.414.
BACKGROUND
Despite its high prevalence, migraine remains underdiagnosed worldwide. A significant reason is the knowledge gap in physicians regarding diagnostic criteria, clinical features, and other clinical aspects of migraine.
AIM
To measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same population.
METHODS
An online questionnaire was developed and distributed among physicians and final year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals, Faisalabad, between October 2018 and October 2019. Inclusion criteria were public practicing physicians who experience headaches, while those who never experienced headaches were excluded. Different questions assessed respondents on their knowledge of triggers, diagnosis, management, and prophylaxis of the migraine headache. They were asked to diagnose themselves using embedded ICHD-3 diagnostic criteria for different types of migraine. Graphs, tables, and figures were made using Microsoft Office 2016 and Microsoft Visio, and data analysis was done in R Studio 1.4.
RESULTS
We had 213 respondents and 175 fulfilled inclusion criteria, with 99 (52%), 58 (30%) and 12 (6.3%) belonging to specialties of medicine, surgery, and others, respectively. Both genders were symmetrically represented (88 male and 87 female). Fifty-two (24.4%) of our 213 respondents were diagnosed with migraine, with 26 (50%) being aware of it. Females had higher prevalence among study participants ( = 28, 32.2%) compared to males ( = 20, 22.7%, = 0.19). A majority (62%) of subjects never consulted any doctor for their headache. Similarly, a majority (62%) either never heard or did not remember the diagnostic criteria of migraine. Around 38% falsely believed that having any type of aura is essential for diagnosing migraine. The consultation rate was 37% ( = 65), and migraineurs were significantly more likely to have consulted a doctor, and a neurologist in particular ( < 0.001). Consulters and migraineurs fared better in the knowledge of diagnostic aspects of the disease than their counterparts. There was no significant difference in other knowledge aspects between consulters non-consulters and migraineurs non-migraineurs.
CONCLUSION
Critical knowledge gaps exist between physicians and medical students, potentially contributing to misdiagnosis and mismanagement of migraine.
背景
尽管偏头痛患病率很高，但在全球范围内仍未得到充分诊断。一个重要原因是医生在偏头痛的诊断标准、临床特征和其他临床方面存在知识差距。
目的
测量医生和医学生的知识缺陷，并评估同一人群中偏头痛的患病率。
方法
2018年10月至2019年10月期间，在费萨拉巴德联合医院和DHQ医院各医学和外科专业值班的医生和医学专业最后一年的学生中开展了一项在线问卷调查。纳入标准为有头痛经历的执业医生，没有头痛经历的被排除。不同问题评估了受访者对偏头痛诱因、诊断、治疗和预防的了解。要求他们使用嵌入式国际头痛疾病分类第三版（ICHD-3）不同类型偏头痛的诊断标准进行自我诊断。使用Microsoft Office 2016和Microsoft Visio制作图表，并在R Studio 1.4中进行数据分析。
结果
我们有213名受访者，175名符合纳入标准，其中99名（52%）、58名（30%）和12名（6.3%）分别来自医学、外科和其他专业。男女比例均衡（88名男性和87名女性）。我们的213名受访者中有52名（24.4%）被诊断患有偏头痛，其中26名（50%）知晓自己患病。研究参与者中女性的患病率高于男性（分别为28名，32.2%和20名，22.7%，P = 0.19）。大多数（62%）受试者从未因头痛咨询过任何医生。同样，大多数（62%）要么从未听说过偏头痛的诊断标准，要么不记得。约38%的人错误地认为有任何类型的先兆是诊断偏头痛的必要条件。咨询率为37%（n = 65），偏头痛患者咨询医生的可能性显著更高，尤其是咨询神经科医生（P < 0.001）。咨询者和偏头痛患者在疾病诊断方面的知识比未咨询者和非偏头痛患者表现更好。在其他知识方面，咨询者与未咨询者以及偏头痛患者与非偏头痛患者之间没有显著差异。
结论
医生和医学生之间存在严重的知识差距，这可能导致偏头痛的误诊和管理不当。
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