Abstract
AimsTo critically appraise, compare and synthesise the quality and acceptability of multi-item patient reported outcome measures for adults with chronic or episodic headache.MethodsSystematic literature searches of major databases (1980–2016) to identify published evidence of PROM measurement and practical properties. Data on study quality (COSMIN), measurement and practical properties per measure were extracted and assessed against accepted standards to inform an evidence synthesis.ResultsFrom 10,903 reviewed abstracts, 103 articles were assessed in full; 46 provided evidence for 23 PROMs: Eleven specific to the health-related impact of migraine (n = 5) or headache (n = 6); six assessed migraine-specific treatment response/satisfaction; six were generic measures. Evidence for measurement validity and score interpretation was strongest for two measures of impact, Migraine-Specific Quality of Life Questionnaire (MSQ v2.1) and Headache Impact Test 6-item (HIT-6), and one of treatment response, the Patient Perception of Migraine Questionnaire (PPMQ-R). Evidence of reliability was limited, but acceptable for the HIT-6. Responsiveness was rarely evaluated. Evidence for the remaining measures was limited. Patient involvement was limited and poorly reported.ConclusionWhile evidence is limited, three measures have acceptable evidence of reliability and validity: HIT-6, MSQ v2.1 and PPMQ-R. Only the HIT-6 has acceptable evidence supporting its completion by all “headache” populations.
Highlights
Headache disorders are common in the adult population; the most common – tension-type and migraine – have a one-year prevalence of 40% and 11% respectively [1,2,3]
The search strategy was developed by experienced reviewers (KH, TM, Role Prevention (RP), SP) and with expert librarian support to retrieve references relating to the development and/or evaluation of multi-item Patient-reported outcome measures (PROMs) used in the assessment of adults with chronic or episodic headache including migraine
Apart from two condition-specific – Headache Impact Test 6-item (HIT-6) and MSQv2.1 – and one treatment-response – Perception of Migraine Questionnaire (PPMQ-R) – measures, for which strong evidence was reviewed, evidence was largely limited or not available. This is the first systematic review to include a methodological assessment of both study and PROM quality in the headache population
Summary
Headache disorders are common in the adult population; the most common – tension-type and migraine – have a one-year prevalence of 40% and 11% respectively [1,2,3]. Between 2–4% of the general population experience chronic headache [4,5]. Headache disorders can profoundly impact an individual’s functional ability and quality of life [3,6]. The personal and economic burden of headache is substantial and comparable to other chronic conditions such as congestive heart failure, hypertension, or diabetes [7]. An individual’s self-report of the presence, severity, frequency, and impact of headache is crucial to understanding the effectiveness of therapeutic interventions.
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