PMC:4144696 / 22726-24106 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/4144696","sourcedb":"PMC","sourceid":"4144696","source_url":"https://www.ncbi.nlm.nih.gov/pmc/4144696","text":"If our inability to validate the survey instruments was a limitation of the study, it was forced upon us. In the case of the headache diagnostic questions, there were no headache experts in Nepal to be the gold standard. This is a situation encountered elsewhere and, if it is seen as an insurmountable barrier, there is no way forward. While HARDSHIP reliably estimates the prevalence of headache, and the attribution of burden to headache disorders, which in public-health terms are of first importance, the relative contributions of migraine and TTH are also of considerable interest because somewhat different health-care provisions are needed for their management. The diagnostic questions of HARDSHIP are based on ICHD-3 beta [16], and have worked with good specificity and reasonable sensitivity (though less so for TTH) in several cultures and languages [6]. The diagnosis of MOH, or more correctly probable MOH, rests on the association in individuals of headache on ≥15 days/month and medication overuse, since there cannot be evidence of causation. The coexistence of these in itself signals ill health regardless of the precise diagnosis [32]. Similar considerations apply to HADS and EPQ-N. These are instruments that have been used and validated widely, and were used with the expectation, but not proof, that they would perform no less well in Nepal than elsewhere.","tracks":[{"project":"2_test","denotations":[{"id":"25146939-24400999-60562912","span":{"begin":863,"end":864},"obj":"24400999"},{"id":"25146939-24500815-60562913","span":{"begin":1151,"end":1153},"obj":"24500815"}],"attributes":[{"subj":"25146939-24400999-60562912","pred":"source","obj":"2_test"},{"subj":"25146939-24500815-60562913","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"2_test","color":"#b593ec","default":true}]}]}}