Waliszewska-Prosół Marta, Montisano Danilo Antonio, Antolak Mariola, Bighiani Federico, Cammarota Francescantonio, Cetta Ilaria, Corrado Michele, Ihara Keiko, Kartamysheva Regina, Petrušić Igor, Pocora Maria Magdalena, Takizawa Tsubasa, Vaghi Gloria, Martelletti Paolo, Corso Barbara, Raggi Alberto
Department of Neurology, Wroclaw Medical University, Wroclaw, Poland.
Dipartimento Di Neuroalgologia, Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy.
J Headache Pain. 2024 Mar 4;25(1):27. doi: 10.1186/s10194-024-01735-0.
The burden and disability associated with headaches are conceptualized and measured differently at patients' and populations' levels. At the patients' level, through patient-reported outcome measures (PROMs); at population level, through disability weights (DW) and years lived with a disability (YLDs) developed by the Global Burden of Disease Study (GBD). DW are 0-1 coefficients that address health loss and have been defined through lay descriptions. With this literature review, we aimed to provide a comprehensive analysis of disability in headache disorders, and to present a coefficient referring to patients' disability which might inform future GBD definitions of DW for headache disorders.
We searched SCOPUS and PubMed for papers published between 2015 and 2023 addressing disability in headache disorders. The selected manuscript included a reference to headache frequency and at least one PROM. A meta-analytic approach was carried out to address relevant differences for the most commonly used PROMs (by headache type, tertiles of medication intake, tertiles of females' percentage in the sample, and age). We developed a 0-1 coefficient based on the MIDAS, on the HIT-6, and on MIDAS + HIT-6 which was intended to promote future DW iterations by the GBD consortium.
A total of 366 studies, 596 sub-samples, and more than 133,000 single patients were available, mostly referred to cases with migraine. Almost all PROMs showed the ability to differentiate disability severity across conditions and tertiles of medication intake. The indexes we developed can be used to inform future iterations of DW, in particular considering their ability to differentiate across age and tertiles of medication intake.
Our review provides reference values for the most commonly used PROMS and a data-driven coefficient whose main added value is its ability to differentiate across tertiles of age and medication intake which underlie on one side the increased burden due to aging (it is likely connected to the increased impact of common comorbidities), and by the other side the increased burden due to medication consumption, which can be considered as a proxy for headache severity. Both elements should be considered when describing disability of headache disorders at population levels.
与头痛相关的负担和残疾在患者层面和人群层面有着不同的概念和衡量方式。在患者层面，通过患者报告结局测量（PROMs）；在人群层面，通过全球疾病负担研究（GBD）制定的残疾权重（DW）和残疾生存年数（YLDs）。DW是用于衡量健康损失的0至1系数，通过外行描述来定义。通过这篇文献综述，我们旨在对头痛疾病的残疾情况进行全面分析，并提出一个反映患者残疾程度的系数，这可能为未来GBD对头痛疾病DW的定义提供参考。
我们在SCOPUS和PubMed数据库中搜索了2015年至2023年期间发表的关于头痛疾病残疾情况的论文。入选的手稿需提及头痛频率且至少包含一项PROM。采用荟萃分析方法探讨最常用PROMs（按头痛类型、药物摄入量三分位数、样本中女性百分比三分位数和年龄）的相关差异。我们基于偏头痛残疾评定量表（MIDAS）、头痛影响测试-6（HIT-6）以及MIDAS+HIT-6开发了一个0至1系数，旨在推动GBD联盟未来对DW的迭代。
共获取366项研究、596个亚样本以及超过133,000例个体患者的数据，其中大部分涉及偏头痛病例。几乎所有PROMs都显示出能够区分不同病情和药物摄入量三分位数下的残疾严重程度。我们开发的指数可用于为DW的未来迭代提供参考，特别是考虑到它们在区分年龄和药物摄入量三分位数方面的能力。
我们的综述提供了最常用PROMs的参考值以及一个数据驱动的系数，其主要附加值在于能够区分年龄和药物摄入量三分位数，一方面这反映了由于衰老导致的负担增加（可能与常见合并症影响增加有关），另一方面反映了由于药物消费导致的负担增加，这可被视为头痛严重程度的一个指标。在描述人群层面头痛疾病的残疾情况时，这两个因素都应予以考虑。
