The Headache-Attributed Lost Time (HALT) Indices: measures of burden for clinical management and population-based research

on behalf of Lifting The Burden: The Global Campaign against Headache

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The burden attributable to headache disorders has multiple components: a simple measure summarising them all does not exist. The Migraine Disability Assessment (MIDAS) instrument has proved useful, estimating productive time lost in the preceding 3 months due to the disabling effect of headache. We developed adaptations of MIDAS for purposes of the Global Campaign against Headache, embracing epidemiological studies and the provision of clinical management aids. Methods: We reviewed the structure, content, wording and scoring of MIDAS and made revisions, developing the Headache-Attributed Lost Time (HALT) Indices in three versions. Over 10 years, these were employed in multiple epidemiological and clinical studies in countries worldwide. Results: In the original HALT-90, we made no changes to the structure and scoring of MIDAS, but used wording in questions 1–4 that we believed would be more widely understood and more easily translated into other languages. Of the two alternative versions, HALT-30 kept the same structure, question format and wording except that “3 months” was replaced by “1 month”. HALT-7/30 was a variant of HALT-30: focusing only on lost work time for population-based studies of headache-attributed burden, it enquired into lost days in the preceding month (30 days) and week (7 days). Conclusions: Three versions of the HALT Indices serve different purposes as measures of headache-attributed burden, and offer different means of scoring. In studies using HALT as a population measure, there is no need to reflect the states of individuals, whereas a measure over shorter periods than 3 months is likely to be more reliable through better recall. Assessment of individual patients prior to treatment may best estimate impact if enquiry is made into the preceding 90 days, except in cases where headache is highly frequent. Follow-up in clinical management may be better served by assessments over 30 rather than 90 days.

Original languageEnglish (US)
Article number12
JournalJournal of Headache and Pain
Volume19
Issue number1
DOIs
StatePublished - Dec 1 2018

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Headache
Research
Population
Migraine Disorders
Epidemiologic Studies
Headache Disorders
Language

Keywords

  • assessment
  • burden
  • Global Campaign against Headache
  • headache disorders
  • instruments
  • management
  • population-based studies

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

The Headache-Attributed Lost Time (HALT) Indices : measures of burden for clinical management and population-based research. / on behalf of Lifting The Burden: The Global Campaign against Headache.

In: Journal of Headache and Pain, Vol. 19, No. 1, 12, 01.12.2018.

Research output: Contribution to journalArticle

on behalf of Lifting The Burden: The Global Campaign against Headache. / The Headache-Attributed Lost Time (HALT) Indices : measures of burden for clinical management and population-based research. In: Journal of Headache and Pain. 2018 ; Vol. 19, No. 1.
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abstract = "Background: The burden attributable to headache disorders has multiple components: a simple measure summarising them all does not exist. The Migraine Disability Assessment (MIDAS) instrument has proved useful, estimating productive time lost in the preceding 3 months due to the disabling effect of headache. We developed adaptations of MIDAS for purposes of the Global Campaign against Headache, embracing epidemiological studies and the provision of clinical management aids. Methods: We reviewed the structure, content, wording and scoring of MIDAS and made revisions, developing the Headache-Attributed Lost Time (HALT) Indices in three versions. Over 10 years, these were employed in multiple epidemiological and clinical studies in countries worldwide. Results: In the original HALT-90, we made no changes to the structure and scoring of MIDAS, but used wording in questions 1–4 that we believed would be more widely understood and more easily translated into other languages. Of the two alternative versions, HALT-30 kept the same structure, question format and wording except that “3 months” was replaced by “1 month”. HALT-7/30 was a variant of HALT-30: focusing only on lost work time for population-based studies of headache-attributed burden, it enquired into lost days in the preceding month (30 days) and week (7 days). Conclusions: Three versions of the HALT Indices serve different purposes as measures of headache-attributed burden, and offer different means of scoring. In studies using HALT as a population measure, there is no need to reflect the states of individuals, whereas a measure over shorter periods than 3 months is likely to be more reliable through better recall. Assessment of individual patients prior to treatment may best estimate impact if enquiry is made into the preceding 90 days, except in cases where headache is highly frequent. Follow-up in clinical management may be better served by assessments over 30 rather than 90 days.",
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author = "{on behalf of Lifting The Burden: The Global Campaign against Headache} and Steiner, {T. J.} and Lipton, {Richard B.} and {Al Jumah}, M. and A. Al-Khathami and M. Allena and C. Andr{\'e}e and I. Ayzenberg and M. Braschinsky and R. Gil-Gouveia and G. G{\"o}kmen and G. Gururaj and A. Herekar and Z. Katsarava and N. Kissani and G. Kulkarni and M. Lainez and C. Lampl and M. Lant{\'e}ri-Minet and M. Linde and O. Luvsannorov and K. Manandhar and E. Mbewe and G. Quispe and G. Rao and D. Rastenytė and A. Risal and {de la Torre}, {E. Ruiz} and S. Schramm and M. Selekler and H. Stokes and {Stokes Brackett}, {A. C.} and Stovner, {L. J.} and C. Tassorelli and R. Tekle-Haimanot and P. Vriezen and Yu, {S. Y.} and M. Zebenigus",
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T1 - The Headache-Attributed Lost Time (HALT) Indices

T2 - measures of burden for clinical management and population-based research

AU - on behalf of Lifting The Burden: The Global Campaign against Headache

AU - Steiner, T. J.

AU - Lipton, Richard B.

AU - Al Jumah, M.

AU - Al-Khathami, A.

AU - Allena, M.

AU - Andrée, C.

AU - Ayzenberg, I.

AU - Braschinsky, M.

AU - Gil-Gouveia, R.

AU - Gökmen, G.

AU - Gururaj, G.

AU - Herekar, A.

AU - Katsarava, Z.

AU - Kissani, N.

AU - Kulkarni, G.

AU - Lainez, M.

AU - Lampl, C.

AU - Lantéri-Minet, M.

AU - Linde, M.

AU - Luvsannorov, O.

AU - Manandhar, K.

AU - Mbewe, E.

AU - Quispe, G.

AU - Rao, G.

AU - Rastenytė, D.

AU - Risal, A.

AU - de la Torre, E. Ruiz

AU - Schramm, S.

AU - Selekler, M.

AU - Stokes, H.

AU - Stokes Brackett, A. C.

AU - Stovner, L. J.

AU - Tassorelli, C.

AU - Tekle-Haimanot, R.

AU - Vriezen, P.

AU - Yu, S. Y.

AU - Zebenigus, M.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: The burden attributable to headache disorders has multiple components: a simple measure summarising them all does not exist. The Migraine Disability Assessment (MIDAS) instrument has proved useful, estimating productive time lost in the preceding 3 months due to the disabling effect of headache. We developed adaptations of MIDAS for purposes of the Global Campaign against Headache, embracing epidemiological studies and the provision of clinical management aids. Methods: We reviewed the structure, content, wording and scoring of MIDAS and made revisions, developing the Headache-Attributed Lost Time (HALT) Indices in three versions. Over 10 years, these were employed in multiple epidemiological and clinical studies in countries worldwide. Results: In the original HALT-90, we made no changes to the structure and scoring of MIDAS, but used wording in questions 1–4 that we believed would be more widely understood and more easily translated into other languages. Of the two alternative versions, HALT-30 kept the same structure, question format and wording except that “3 months” was replaced by “1 month”. HALT-7/30 was a variant of HALT-30: focusing only on lost work time for population-based studies of headache-attributed burden, it enquired into lost days in the preceding month (30 days) and week (7 days). Conclusions: Three versions of the HALT Indices serve different purposes as measures of headache-attributed burden, and offer different means of scoring. In studies using HALT as a population measure, there is no need to reflect the states of individuals, whereas a measure over shorter periods than 3 months is likely to be more reliable through better recall. Assessment of individual patients prior to treatment may best estimate impact if enquiry is made into the preceding 90 days, except in cases where headache is highly frequent. Follow-up in clinical management may be better served by assessments over 30 rather than 90 days.

AB - Background: The burden attributable to headache disorders has multiple components: a simple measure summarising them all does not exist. The Migraine Disability Assessment (MIDAS) instrument has proved useful, estimating productive time lost in the preceding 3 months due to the disabling effect of headache. We developed adaptations of MIDAS for purposes of the Global Campaign against Headache, embracing epidemiological studies and the provision of clinical management aids. Methods: We reviewed the structure, content, wording and scoring of MIDAS and made revisions, developing the Headache-Attributed Lost Time (HALT) Indices in three versions. Over 10 years, these were employed in multiple epidemiological and clinical studies in countries worldwide. Results: In the original HALT-90, we made no changes to the structure and scoring of MIDAS, but used wording in questions 1–4 that we believed would be more widely understood and more easily translated into other languages. Of the two alternative versions, HALT-30 kept the same structure, question format and wording except that “3 months” was replaced by “1 month”. HALT-7/30 was a variant of HALT-30: focusing only on lost work time for population-based studies of headache-attributed burden, it enquired into lost days in the preceding month (30 days) and week (7 days). Conclusions: Three versions of the HALT Indices serve different purposes as measures of headache-attributed burden, and offer different means of scoring. In studies using HALT as a population measure, there is no need to reflect the states of individuals, whereas a measure over shorter periods than 3 months is likely to be more reliable through better recall. Assessment of individual patients prior to treatment may best estimate impact if enquiry is made into the preceding 90 days, except in cases where headache is highly frequent. Follow-up in clinical management may be better served by assessments over 30 rather than 90 days.

KW - assessment

KW - burden

KW - Global Campaign against Headache

KW - headache disorders

KW - instruments

KW - management

KW - population-based studies

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