Abstract:For methodological reasons our study may underestimate the true prevalence of migraine in Germany. Taking our rather "conservative" figures into account, our study reveals, however, that there are more than 2 million migraine sufferers in Germany between 16 and 69 years of age.
“…In many cases, sample sizes were greatly reduced by high levels of non-participation [ 40 - 45 ]. We found, more seriously because no remedy could be offered, other studies in which levels of participation were not reported [ 20 , 21 , 33 , 37 , 38 , 46 - 79 ].…”
Population-based studies of headache disorders are important. They inform needs assessment and underpin service policy for a set of disorders that are a public-health priority. On the one hand, our knowledge of the global burden of headache is incomplete, with major geographical gaps; on the other, methodological differences and variable quality are notable among published studies of headache prevalence, burden and cost.The purpose here was to start the process of developing standardized and better methodology in these studies. An expert consensus group was assembled to identify the key methodological issues, and areas where studies might fail. Members had competence and practical experience in headache epidemiology or epidemiology in general, and were drawn from all WHO world regions. We reviewed the relevant literature, and supplemented the knowledge gathered from this exercise with experience gained from recent Global Campaign population-based studies, not all yet published. We extracted methodological themes and identified issues within them that were of key importance.We found wide variations in methodology. The themes within which methodological shortcomings had adverse impact on quality were the following: study design; selection and/or definition of population of interest; sampling and bias avoidance; sample size estimation; access to selected subjects (managing and reporting non-participation); case definition (including diagnosis and timeframe); case ascertainment (including diagnostic validation of questionnaires); burden estimation; reporting (methods and results). These are discussed.
“…In many cases, sample sizes were greatly reduced by high levels of non-participation [ 40 - 45 ]. We found, more seriously because no remedy could be offered, other studies in which levels of participation were not reported [ 20 , 21 , 33 , 37 , 38 , 46 - 79 ].…”
Population-based studies of headache disorders are important. They inform needs assessment and underpin service policy for a set of disorders that are a public-health priority. On the one hand, our knowledge of the global burden of headache is incomplete, with major geographical gaps; on the other, methodological differences and variable quality are notable among published studies of headache prevalence, burden and cost.The purpose here was to start the process of developing standardized and better methodology in these studies. An expert consensus group was assembled to identify the key methodological issues, and areas where studies might fail. Members had competence and practical experience in headache epidemiology or epidemiology in general, and were drawn from all WHO world regions. We reviewed the relevant literature, and supplemented the knowledge gathered from this exercise with experience gained from recent Global Campaign population-based studies, not all yet published. We extracted methodological themes and identified issues within them that were of key importance.We found wide variations in methodology. The themes within which methodological shortcomings had adverse impact on quality were the following: study design; selection and/or definition of population of interest; sampling and bias avoidance; sample size estimation; access to selected subjects (managing and reporting non-participation); case definition (including diagnosis and timeframe); case ascertainment (including diagnostic validation of questionnaires); burden estimation; reporting (methods and results). These are discussed.
“…Neuere Erhebungen [10] zeigen, daß über 20% der Bevölkerung zumindest sporadisch unter Kopfschmerzen leiden und daß 3,6% Migräneat-tacken nach den Definitionskriterien der IHS [13] beschreiben. Goebel et al [12] ermittelten die Lebenszeitpräva-lenz bei 4061 Personen, welche von 5000 repräsentativen Bürgern bei einer Fragebogenaktion antworteten.…”
Acupuncture is being increasingly used as one of the most important non-pharmacological therapies in treatment of chronic pain. Chronic headache, especially migraine and tension headache are diseases frequently encountered. In their treatment acupuncture is a method with very few side effects and is a remarkable alternative or addition in the whole concept of treatment. Open and placebo-controlled studies have shown that acupuncture reduces the frequency and intensity of headache in many patients, as well as the use of drugs. The success rates achieved of about 50-85% are comparable to the results of other methods. In the case of migraine, especially good results are archived by prophylactic treatment with acupuncture during the pain-free period. The concept of treatment depends on the basic rules of traditional Chinese medicine (TCM). Selection of the acupuncture points is primarily determined by the pain site. Long-term success could be confirmed by follow-up examinations six to eighteen months after end of the therapy.
“…Grund sätzlich muss man dabei Querschnittsstudien (eine Personengrup pe wird zu einem Zeitpunkt untersucht) von Längsschnittsstudien (eine Personengruppe wird über einen Zeitraum wiederholt oder kontinuierlich untersucht) unterscheiden. Bei den häufigeren Quer [3].…”
ZUSAMMENFASSUNGEpidemiologische Daten sind in den letzten Jahren zunehmend in den Fokus des medizinischen Interesses gerückt, da sie neben der Abschätzung der für die Behandlung der Erkrankung notwendigen Ressourcen auch Hinweise auf ätiologische oder pathophysiologische Zusammenhänge geben können. Für die Erkrankungen aus dem Gebiet der primären Kopfschmerzen gibt es seit Anfang 2000 aussagekräftige Studien, die fast ausschließlich als Querschnittserhebungen konzipiert waren. Die 12-Monats-Prävalenz für Kopfschmerzen allgemein liegt in Deutschland bei ca. 60 %, wobei Kinder und Jugendliche genauso betroffen sind wie Erwachsene. Die Prävalenz der Migräne liegt im Mittel über alle Studien bei etwa 10 %, die des Spannungskopfschmerzes bei ca. 16 % bis 18 % und für den Clusterkopfschmerz bei 0,1 % bis 0,2 %. Ein Zusammenhang von Kopfschmerzen und subjektiv erlebten Stress lässt sich für alle Altersgruppen nachweisen. Belastbare Daten zum Einfluss von Therapien, Lebensstilmodifikationen und genetischer Faktoren fehlen. In der Zukunft ist zu hoffen, dass entsprechende Langzeitbeobachtungen durchgeführt werden.
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