scholarly journals The Public’s Perception of Interventions for Migraine Headache Disorders: A Crowdsourcing Population-Based Study

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Orr Shauly ◽  
Daniel J Gould ◽  
Ketan M Patel
Keyword(s):  
Migraine Headache ◽  
Treatment Options ◽  
The United States ◽  
Cost Of Care ◽  
Adverse Outcomes ◽  
Amazon Mechanical Turk ◽  
Cross Sectional ◽  
Economic Productivity ◽  
Migraine Headaches ◽  
Patient Reported

Abstract Background Migraine disorders are a leading cause of morbidity and decreased economic productivity in the United States among both men and women. As such, it is important to consider patient opinions, and have an accurate representation of the burden and sentiment toward currently available interventions among those suffering from migraines. Objectives The aim of the study was to assess patient options regarding adverse outcomes of the various treatment options available for migraine headaches. Methods A prospective cross-sectional study of volunteers recruited through an internet crowdsourcing service, Amazon Mechanical Turk©, was conducted. Surveys were administered to collect patient-reported opinions regarding adverse outcomes of both surgical and nonsurgical treatment options for migraine headaches. Results The prevalence of migraine headache across all study participants was 15.6% and varied slightly across participant demographics. Individuals ages 35–44 (2.73 migraines per month) experienced the fewest migraine and with the lowest severity. Those individuals ages 45+ experienced the most severe headaches (Visual Analog Scale = 44.23 mm). Additionally, the greatest migraine frequency and severity existed among those households with yearly income of $75,000–$100,000. The lowest injection therapy utility scores were obtained for adverse outcomes of hematoma (47.60 mm) and vertigo (54.40 mm). Conclusions Migraine headaches remains a significant problem among the US population, with an overall prevalence of 15.6% (approximately 50 million Americans). Additionally, physicians interesting in offering minimally invasive or surgical treatment for migraine headaches should focus on mitigating patient fears regarding clinical outcomes and cost of care.

Self-perceived attention deficit and hyperactivity symptom levels and risk of non-migraine and migraine headaches among university students: A cross-sectional study

Cephalalgia ◽  
2018 ◽  
Vol 39 (6) ◽  
pp. 711-721 ◽  
Author(s):  
Claire Carpenet ◽  
Elie Guichard ◽  
Christophe Tzourio ◽  
Tobias Kurth
Keyword(s):  
University Students ◽  
Migraine With Aura ◽  
Attention Deficit ◽  
Migraine Headache ◽  
Cross Sectional Study ◽  
Self Report ◽  
Cross Sectional ◽  
Hyperactivity Disorder ◽  
Migraine Headaches ◽  
Symptom Level

Objectives The aim was to evaluate the association of self-perceived levels of attention deficit and hyperactivity symptoms with non-migraine and migraine headaches among university students. We also evaluated their association with migraine aura. Methods Study subjects were all participants in the internet-based Students Health Research Enterprise. Scores were built to evaluate global attention and hyperactivity symptom levels, self-perceived attention deficit levels and self-perceived hyperactivity symptom levels based on the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale (ASRS v1.1.). We used standardised questions to classify headache and group participants into “no headache,” “non-migraine headache,” “migraine without aura” or “migraine with aura”. Results A total of 4816 students were included (mean age 20.3 ± 2.8 years; 75.5% women). Compared with participants without headache, we found significant associations between global ADHD scores and migraine. Students in the highest quintile of global ASRS scores had adjusted odds ratio (aOR) of 1.95 (95% CI 1.56–2.45) when compared to the lowest. This association was mainly driven by an association between self-perceived hyperactivity and migraine with aura. The aOR for migraine with aura was 2.83 (95% CI 2.23–3.61) for students in the highest quintile of hyperactivity. No significant association was found for any attention and hyperactivity symptom level measure and non-migraine headache and between self-perceived levels of attention deficit and migraine. Conclusions Among students in higher education in France, self-perceived levels of attention deficit and hyperactivity symptoms were selectively associated with migraine. The association was strongest for the hyperactivity domain and migraine with aura.

Implementing value-based cancer care: A multidisciplinary approach to defining breast cancer outcomes.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 16-16
Author(s):  
Oluwadamilola M. Fayanju ◽  
Tinisha L. Mayo ◽  
Tracy E. Spinks ◽  
Seohyun Lee ◽  
Carlos Hernando Barcenas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Performance Improvement ◽  
Cancer Care ◽  
Treatment Options ◽  
The United States ◽  
Multidisciplinary Teams ◽  
Patient Portal ◽  
Breast Cancer Patients ◽  
Patient Centered ◽  
Patient Reported

16 Background: Value in healthcare (patient-centered outcomes achieved per dollar spent) unifies performance improvement goals with health outcomes of importance to patients. We describe the process through which value-based measures for breast cancer patients and dynamic capture of these metrics via our new electronic health record (EHR) were developed at our institution. Methods: A review of the breast cancer literature was conducted on treatment options as well as expected outcomes and potential treatment complications. Patient perspective was obtained via focus groups. Multidisciplinary teams met to inform a 3-phase process of (1) concept development, (2) measure specification, and (3) implementation via EHR integration, planned for spring 2016. Results: Outcomes were divided into 3 previously defined tiers (NEJM 2010; 363:2477-2481) that reflect the entire cycle of care (Table).Within these tiers, 22 patient-centered outcomes were defined with inclusion/exclusion criteria, specifications for reporting, and sources for data including the EHR and validated patient-reported outcome questionnaires (e.g., FACT-B+4) administered via our patient portal. Conclusions: A value-based approach to cancer care with transparently reported patient outcomes not only creates opportunity for performance improvement but also enables benchmarking within and across providers, healthcare systems, and even countries. Our value-based framework for breast cancer is the first of its kind in the United States, with a similar model being pursued internationally as well. [Table: see text]

Identifying education, knowledge and communication gaps in biomarker testing between YO-CRC patients, caregivers, and their medical team.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16115-e16115
Author(s):  
Kim Lynn Newcomer ◽  
Danielle Peterson ◽  
Ronit Yarden ◽  
Keyword(s):  
Online Survey ◽  
Medical Information ◽  
Treatment Plan ◽  
Treatment Options ◽  
Stage Iv ◽  
Public Health Issue ◽  
Medical Team ◽  
Cross Sectional ◽  
Patient Reported ◽  
Biomarker Testing

e16115 Background: The proportion of new young-onset colorectal cancer (YO-CRC) cases diagnosed in young people (20-49) had doubled over the past 3 decades, and it is becoming an alarming public health issue. YO-CRC patients face unique clinical challenges, as many are diagnosed at advanced stages of the disease and subjected to aggressive treatments. With the increase of targeted therapies and precision medicine available, NCCN and ASCO guidelines recommend that all stage IV, metastatic CRC patients be tested for 4 biomarkers in addition to MSI-H. However, not all eligible patients benefit from biomarker testing and biomarker-driven therapies. Methods: We conducted an online survey to assess patients, survivors and caregivers’ knowledge and understanding of biomarker testing and whether they feel empowered to discuss with their doctor different treatment options based on their unique tumor characteristics and their preferences. Results: The cross-sectional study was completed by patients and survivors (N = 885) and unrelated caregivers of YO-CRC patients (N = 203). The median age of patients and survivors was 42, and the median age of caregivers was also 42. The majority of the participants were college graduates. Although 82% of stage IV, YO-CRC patients felt informed before treatment began, only 70% indicated their tumor was tested for biomarkers, and 54% of them received biomarker testing before treatment initiation. Only 33% of patients reported they became aware of biomarkers by their medical team while others indicated resources such as internet searches, family and friends, or patient navigators. Many of the caregivers who reported that they served as a liaison between patients and medical information retrieval felt that they did not fully understand the critical aspects of the patients' medical treatment plan. Conclusions: Multiple studies have shown that patient-centered care improves patients’ outcomes. Our organization encourages patients and their families to use medical information to navigate their journey. Our patient-reported study suggests that there are gaps in patients’ and caregiver’s understanding of biomarker testing that may hinder patient's empowerment for reaching evidence-based shared-decision treatment plan together with their physicians.

scholarly journals Patient-Reported Symptom Severity in a Nationwide Myasthenia Gravis Cohort: Cross-sectional Analysis of the Swedish GEMG Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012604
Author(s):  
Malin Petersson ◽  
Amalia Feresiadou ◽  
Daniel Jons ◽  
Andreea Ilinca ◽  
Fredrik Lundin ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Disease Duration ◽  
Late Onset ◽  
Treatment Options ◽  
Diagnostic Delay ◽  
Cross Sectional ◽  
Disease Subtype ◽  
Genes And Environment ◽  
Patient Reported ◽  
Sectional Analysis

Objectives:To describe Myasthenia Gravis-Activities of Daily Living (MG-ADL) in relation to clinical characteristics in a large Swedish nationwide cohort.Methods:In a cross-sectional prevalent cohort study, the Genes and Environment in Myasthenia Gravis study (GEMG), performed November 2018 - August 2019, Myasthenia gravis (MG) patients were invited to submit an extensive 106-item life environment questionnaire, including the MG-ADL score. Patients were classified into early onset MG (EOMG, <50 years), late onset MG (LOMG, ≥50 years) or thymoma-associated MG (TAMG). Comparisons of disease-specific characteristics were made between subgroups, sex and different MG-ADL scores.Results:A total of 1077 patients were included, yielding a 74% response rate: 505 (47%) were classified as EOMG, 520 (48%) LOMG and 45 (4%) TAMG. Mean age at inclusion was 64.3 years (SD 15.7) and mean disease duration was 14.6 years (SD 14.0). Complete MG-ADL scores (n=1035) ranged from 0-18p, where 26% reported a score of 0p. Higher MG-ADL scores were associated with female sex, obesity and diagnostic delay (OR=1.62, 1.72 and 1.69, Padj=0.017, 0.013 and 0.008) and inversely correlated with high educational attainment (OR=0.59, Padj=0.02), but not with age at inclusion, disease subtype nor disease duration. Almost half the population (47%) reported MG-ADL ≥3p, corresponding to an unsatisfactory symptom state.Conclusions:In this nationwide study, comprising more than 40% of the prevalent MG population in Sweden, we observe that almost half of patients report current disease symptoms associated to an unsatisfactory symptom state, indicating the need for improved treatment options.

scholarly journals The Frequency of Food Allergy Among Children With Migraine Headache; A Descriptive Cross-Sectional Study

2020 ◽  
Vol 14 (1) ◽  
pp. 46-52
Author(s):  
Akefeh Ahmadiafshar ◽  
Mohammad Vafaee-Shahi ◽  
Saeide Ghasemi ◽  
Fariba Khosroshahi ◽  
Aina Riahi
Keyword(s):  
Food Allergy ◽  
Skin Test ◽  
Migraine Headache ◽  
Critical Role ◽  
Food Allergies ◽  
Cross Sectional ◽  
Positive Skin ◽  
Migraine Headaches ◽  
Allergy Test ◽  
History Of

Background: Headache and particularly migraine headaches are considered as a debilitating disease worldwide that can adversely affect the quality of life of children and adults. Various factors can play a critical role in the development of migraine headache attacks. The food allergens are considered as important factors. This study aimed to determine the frequency of food allergy in children with migraine headaches. Methods: Forty patients aged <16 years with a migraine headache were entered into the study. A questionnaire was provided in which data on demographic information and skin test results for various allergens were recorded. Dietary allergies were defined based on a positive skin test plus a patient's history of food allergies. The severity of migraine was evaluated using the Migraine disability assessment score (MIDAS) questionnaire. Results: The present study showed 32.5% of our participants had a food allergy. No significant association was detected between sex (p=58) and age (p=0.14) with food allergy. However, the frequency of food allergy was significantly higher in patients aged ≥12 years old (44.4%) than those aged <12 (22.7%). A significant relationship was found between the number of attacks after prophylaxis and the frequency of food allergies (p=0.032). Individuals with lower attacks had a lower food allergy. Conclusion: Our findings revealed that about one-third of children with a migraine headache had a food allergy. This frequency was significantly higher in children with migraines than that of the general population based on the results of previous studies. It is recommended that these patients receive a skin allergy test while preparing a strong history of food allergies or when the frequency of migraine attacks does not decrease significantly despite proper prophylaxis.

Age at menarche and risk of developing migraine or non-migraine headaches by young adulthood: A prospective cohort study

Cephalalgia ◽  
2016 ◽  
Vol 37 (13) ◽  
pp. 1257-1263 ◽  
Author(s):  
Nasim Maleki ◽  
Tobias Kurth ◽  
Alison E Field
Keyword(s):  
Cohort Study ◽  
Family History ◽  
Young Adulthood ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Migraine Headache ◽  
The United States ◽  
Age At Menarche ◽  
Migraine Headaches ◽  
History Of

Importance Migraine is a highly prevalent and disabling primary headache disorder that is two to three times more prevalent in young women. Among females, there is a steep increase in incidence from puberty to young adulthood, but the mechanisms for the increase are unknown. Objective To determine if age of menarche is a risk factor for developing migraine headache vs. non-migraine headache by young adulthood. Design A prospective cohort study, The Growing Up Today Study (GUTS), of adolescents who have been followed since 1996, when they were nine, to 14 years of age. Headache questions were included on the 2007 and 2010 surveys. Setting Youth from across the United States who are offspring of women participating in the Nurses’ Health Study II. Participants 6112 female participants who had provided data on headache symptoms, age at menarche and family history of migraine and were followed through 2007 or 2010 were included in this analysis. Main outcomes Migraine or non-migraine headache. Results Many females had a history of headaches, with approximately equal numbers reporting symptoms consistent with migraine (29.7%) and non-migraine headaches (25.3%). We found that, independent of age and family history of migraine, each one-year delay in onset of menarche decrease the odds of migraine by 7% (odds ratio (OR) = 0.93, 95% confidence interval (CI) 0.89–0.97), but was not related to non-migraine headaches. Conclusions and relevance The findings of this study suggest that early puberty increases the risk of developing migraines by young adulthood. As such, the study emphasizes the need for understanding the pathophysiological links between puberty and developmental changes that occur in the brain during that period and the mechanisms of onset of the migraine disease and its trajectory.

A Cross-Sectional Study of Pain Among U.S. College Music Students and Faculty

2017 ◽  
Vol 32 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Jeremy L Stanek ◽  
Kevin D Komes ◽  
Fred A Murdock
Keyword(s):  
Performing Arts ◽  
Large Scale ◽  
Online Survey ◽  
Treatment Options ◽  
The United States ◽  
Cross Sectional Study ◽  
Medical Professional ◽  
College Level ◽  
Cross Sectional ◽  
The Right

OBJECTIVES: Studies over recent decades have demonstrated significant performance-related pain among professional musicians. However, there have been no large-scale studies to evaluate pain among college musicians. The aim of this study was to determine the prevalence and anatomical locations of performance-related pain among students and faculty at the college level and learn what musicians do when they have pain. METHODS: Cross-sectional data were collected using an online survey distributed to colleges across the United States. Data were analyzed using REDCap electronic data capture tools and Microsoft Excel. RESULTS: We received 1,007 survey responses and found that 67% of musicians at colleges experienced performance-related pain. The highest prevalence of pain was in woodwind musicians, with 83% reporting performance-related pain. The most common locations of pain were upper back (27%), lower back (26%), and fingers of the right hand (25%). Many student musicians with pain seek help from their teacher, but almost as many do not seek help at all. Less than 25% see a medical professional. CONCLUSIONS: Most musicians at colleges experience performance-related pain in a variety of anatomical locations depending upon instrument/voice. Performing arts health organizations can increase awareness of treatment options for musicians suffering from performance-related pain, which may lead to improved quality of life and increased career longevity for college musicians.

scholarly journals Patient-Reported Burden of Dry Eye Disease in the United States: Results of an Online Cross-Sectional Survey

2020 ◽  
Vol 216 ◽  
pp. 7-17
Author(s):  
Reza Dana ◽  
Juliette Meunier ◽  
Jessica T. Markowitz ◽  
Corey Joseph ◽  
Csaba Siffel
Keyword(s):  
United States ◽  
Dry Eye ◽  
The United States ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Reported

scholarly journals Utilization trends in inpatient endoscopic retrograde cholangiopancreatography (ERCP): A cross-sectional US experience

2017 ◽  
Vol 05 (04) ◽  
pp. E261-E271 ◽  
Author(s):  
Moiz Ahmed ◽  
Ritesh Kanotra ◽  
Ghanshyambhai Savani ◽  
Fenilkumar Kotadiya ◽  
Nileshkumar Patel ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Cost Of Care ◽  
Categorical Variables ◽  
Significant Shift ◽  
Continuous Variables ◽  
Endoscopic Retrograde ◽  
Cross Sectional ◽  
The Mean

Abstract Study aims The goal of our study was to determine the current trends for inpatient utilization for endoscopic retrograde cholangiopancreatography (ERCP) and its economic impact in the United States between 2002 and 2013. Patients and methods A Nationwide Inpatient Sample from 2002 through 2013 was examined. We identified ERCPs using International Classification of Diseases (ICD-9) codes; Procedure codes 51.10, 51.11, 52.13, 51.14, 51.15, 52.14 and 52.92 for diagnostic and 51.84, 51.86, 52.97 were studied. Rate of inpatient ERCP was calculated. The trends for therapeutic ERCPs were compared to the diagnostic ones. We analyzed patient and hospital characteristics, length of hospital stay, and cost of care after adjusting for weighted samples. We used the Cochran-Armitage test for categorical variables and linear regression for continuous variables. Results A total of 411,409 ERCPs were performed from 2002 to 2013. The mean age was 59 ± 19 years; 61 % were female and 57 % were white. The total numbers of ERCPS increased by 12 % from 2002 to 2011, which was followed by a 10 % decrease in the number of ERCPs between 2011 and 2013.There was a significant increase in therapeutic ERCPs by 37 %, and a decrease in diagnostic ERCPs by 57 % from 2002 to 2013. Mean length of stay was 7 days (SE = 0.01) and the mean cost of hospitalization was $20,022 (SE = 41). Conclusions Our large cross-sectional study shows a significant shift in ERCPs towards therapeutic indications and a decline in its conventional diagnostic utility. Overall there has been a reduction in inpatient ERCPs.

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