Development and validation of a telephone classification interview for common chronic headache disorders
Development and validation of a telephone classification interview for common chronic headache disorders
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DOI：
10.1186/s10194-018-0954-z
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发表时间：
2019-01-08
影响因子：
7.4
通讯作者：
Matharu, Manjit
中科院分区：
文献类型：
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作者：
Potter, Rachel;Hee, Siew Wan;Matharu, Manjit
背景：为了对慢性头痛患者进行支持性自我管理的试验，我们需要开发并验证一种电话分类访谈，非头痛专家可以使用该访谈对初级保健中常见的慢性头痛类型进行分类。我们的具体目标是：排除药物过度使用以外的继发性头痛，排除偏头痛和紧张性头痛（TTH）以外的原发性头痛疾病，区分慢性偏头痛和慢性TTH，并确定药物过度使用头痛。方法召开头痛分类共识会议，收集证据和专业知识，为分类访谈提供逻辑模型的内容。接受过使用逻辑模型训练的护士对从初级保健部门招募的参与者进行了电话分类访谈。专门治疗头痛的医生进行了第二次验证性访谈。结果26名代表参加了头痛分类会议，包括头痛专科医生、护士和基层代表（慢性头痛）。我们培训6名护士进行分类访谈，完成107次配对访谈，访谈间隔中位数为32天（四分位数间距21 ~ 48天）。我们使用一致性比例、简单kappa和流行调整偏差调整kappa （PABAK）来测量护士和医生访谈之间的一致性水平。护士与医生访谈的一致性比例为0.76，简单卡帕系数为0.31 (95% CI, 0.09 ~ 0.52)， PABAK为0.51 (95% CI, 0.35 ~ 0.68)，为中等一致性。在回顾头痛特征记录后的敏感性测试中，一致性为0.91,=0.53 (95% CI， 0.28至0.79)，PABAK=0.81 (95% CI， 0.70至0.92)，一致性非常好。结论我们开发并验证了一种新的基于证据的电话分类访谈，可用于非头痛专科医生对初级保健中常见的慢性头痛类型进行分类。
BackgroundFor a trial of supportive self-management for people with chronic headache we needed to develop and validate a telephone classification interview that can be used by a non-headache specialist to classify common chronic headache types in primary care. We aimed to specifically: exclude secondary headaches other than medication overuse, exclude primary headache disorders other than migraine and tension type headache (TTH), distinguish between chronic migraine and chronic TTH, and identify medication overuse headache.MethodsWe held a headache classification consensus conference to draw on evidence and expertise to inform the content of a logic model underpinning the classification interview. Nurses trained to use the logic model did telephone classification interviews with participants recruited from primary care. Doctors specialising in headache did a second validation interview.ResultsTwenty-six delegates attended the headache classification conference including headache specialist doctors, nurses and lay representatives (with chronic headache). We trained six nurses to do the classification interviews and completed 107 paired interviews, median days between interviews was 32days (interquartile range 21-48days). We measured level of agreement between the nurse and doctor interviews using proportion of concordance, simple kappa and prevalence-adjusted bias-adjusted kappa (PABAK). Proportion of concordance of agreement between nurse and doctor interviews was 0.76, simple kappa coefficient 0.31 (95% CI, 0.09 to 0.52), and PABAK 0.51 (95% CI, 0.35 to 0.68), a moderate agreement. In a sensitivity test following review of headache characteristics recorded, concordance was 0.91, =0.53 (95% CI, 0.28 to 0.79), and PABAK=0.81 (95% CI, 0.70 to 0.92), a very good agreement.ConclusionWe developed and validated a new evidence-based telephone classification interview that can be used by a non-headache specialist to classify common chronic headache types in primary care.