Article

Development of a patient-based grading scale for PedMIDAS

Division of Neurology, Cincinnati Children's Hospital Medical Center, OH 45229-3039, USA.
Cephalalgia (Impact Factor: 4.12). 11/2004; 24(10):844-9. DOI: 10.1111/j.1468-2982.2004.00757.x
Source: PubMed

ABSTRACT The objective was to develop and validate a patient-based grading scale for PedMIDAS. PedMIDAS was administered to 329 children, who rated their overall disability based on the adult MIDAS grades. This patient-based rating and PedMIDAS scores were compared to develop the grading scale. Headache disability was rated little to none, 49.5%; mild, 26.7%; moderate, 15.8%; and severe, 7.9%, with PedMIDAS raw scores of 4.9 +/- 6.3, 17.8 +/- 14.9, 40.6 +/- 34.2, and 91.4 +/- 69.8. Convergence of these results yielded an empirically derived grading system: Grade I, 0-10; II, 11-30; III, 31-50 and IV, > 50. Higher grades corresponded to an increased need for prophylactic treatment. A patient-based grading scale further increases the utility of PedMIDAS in assessing migraine disability in children, so that it can be widely used in routine clinical evaluation and management.

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    • "school, home activities, play and social activities). The total score was used by Hershey et al. (2004) to grade disability according to four categories (none–severe). So far, the PedMIDAS has been applied in several clinical studies (Hershey et al., 2001, 2004, 2007; Lewis and Paradiso, 2007; Pakalnis et al., 2007; Gutiérrez-Mata et al., 2008; Fan et al., 2009) and two epidemiological studies (Akyol et al., 2007; Wang et al., 2009), but was not always thoroughly analyzed regarding response characteristics. "
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    ABSTRACT: The study aimed at the assessment of disability in children with headache (n=1585, 11-14 yrs) from a randomly drawn population based sample. We explored the suitability of the PedMIDAS in epidemiological research by various indicators of response quality. Furthermore, predictors of disability were examined, as well as its association with measures of health care behaviour. The PedMIDAS measures functional interference in different domains of life by asking the children for the number of days that their headache partially or totally interfered with their activities. The examination of response behaviour revealed a marked attrition of responses (missing, invalid) in two items. As a consequence, the total score for disability could not be obtained for about 25% of the children. Analysis of homogeneity of the PedMIDAS items revealed low item/total correlations in two items. The grading of disability resulted in 81.2% of all children with headache showing no or low disability. Only 1.4% was "severely" disabled. Disability was predicted by frequency, type and intensity of headache. From all psychological variables only dysfunctional stress coping was significantly associated with disability. Disability itself was significantly associated with medical consultation. Suitability of the PedMIDAS for epidemiological research was supported, however with a caveat and recommendations for item revision. Severe disability due to headache was rare in the studied unselected sample when defined by behavioural interference. It is suggested to explore the construct of disability by a multi-method approach, including further instruments assessing headache related distress, (respectively) quality of life.
    European journal of pain (London, England) 03/2010; 14(9):951-8. DOI:10.1016/j.ejpain.2010.02.010 · 3.22 Impact Factor
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    • "Although no defi ned frequency exists for preventative treatment, typically having more than 2–3 headaches per month warrants treatment. This determination can be augmented by a disability instrument such as PedMIDAS (Hershey et al 2001, 2004). 3 . "
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    ABSTRACT: Headaches in children and adolescents are still under-diagnosed. 75% of children are affected by primary headache by the age of 15 with 28% fitting the ICHD2 criteria of migraine. Migraine is considered a chronic disorder that can severely impact a child's daily activities, including schooling and socializing. Early recognition and aggressive therapy, with acute and prophylactic treatments, as well as intensive biobehavioral interventions, are essential to control the migraine attacks and reverse the progression into intractable disabling headache.
    Neuropsychiatric Disease and Treatment 07/2008; 4(3):535-48. DOI:10.2147/NDT.S495 · 2.15 Impact Factor
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    ABSTRACT: Background Chronic pediatric headache disorders are pervasive, debilitating, and associated with high rates of comorbid anxiety disorders. The combination of headaches and anxiety presents unique challenges for clinicians. Cognitive behavioral therapy (CBT) is a promising treatment for pediatric headache, however, available treatments fail to adequately address comorbid psychopathology resulting in less than optimal response rates. Objective This case study illustrates the use of a family-based CBT for treating comorbid pediatric headache and anxiety disorders. Methods A 10 year old boy with chronic daily headache was evaluated and treated as part of the Children’s Headache and Anxiety Management Program (CHAMP). The patient and his parents were evaluated by an independent evaluator (IE) at pre- and post-treatment and one-month follow-up. Evaluations consisted of structured interviews as well as parent and child self-report measures of headache and anxiety symptoms and impairment. At baseline the child met diagnostic criteria for chronic headache disorder, separation (SAD), and generalized anxiety disorders (GAD), and had significant symptoms of obsessive–compulsive disorder (OCD). Treatment included 8 conjoint sessions of CBT. Results Post-treatment evaluation revealed a significant reduction in headache-related severity and disability (but not frequency), and loss of initial GAD (but not SAD) diagnosis. By the one-month follow-up, the child no longer met criteria for any anxiety disorder and was no longer disabled by headaches. The case highlights how CHAMP may be effective in reducing headache and anxiety symptoms and associated impairment. Conclusions This case illustrates the challenges in treating this population and suggests specific interventions that might enhance treatment outcome.
    Child and Youth Care Forum 12/2012; 41(6). DOI:10.1007/s10566-012-9174-x · 1.25 Impact Factor