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Hoe het elektronisch dagboek helpt bij de diagnose van migraine

Wij gebruiken al geruime tijd e-dagboeken voor onderzoek naar migraine. Deze week publiceerde Daphne van Casteren en collega’s hun studie over hoe het e-dagboek gebruikt ook kan worden voor de diagnose van migraine.

Telemedicine is emerging in this era with restrictions on physical consultations due to corona measures. Headache researchers from the Leiden University Medical Center (LUMC) showed that the implementation of an electronic diary (E-diary) enables continuation of consultations with migraine patients by visualizing E-diary data in the electronic patient records during video-consultation.

The researchers have developed an E-diary which was implemented at the Leiden Headache Clinic. Daphne van Casteren and Iris Verhagen, researchers, have performed the study under the supervision of neurologist Gisela Terwindt from the LUMC. An introduction on the E-diary has been published in Cephalalgia, the medical journal of the International Headache Society.

The E-diary can be distinguished from other commercially available electronic headache diaries by the inclusion of an automated algorithm differentiating headache and migraine days based on detailed characteristics according to international migraine criteria. Therefore, the E-diary is a more objective tool compared to other existing tools that only ask for self-reported headache and migraine days.

The need to use E-diaries in clinical practice was emphasized by the finding that migraine patients do not accurately estimate monthly migraine-related frequencies. Underestimation and overestimation of migraine days and days with acute medication use might have major consequences for the chance of a good clinical response to a new treatment. As an example, migraine patients underestimating their acute medication intake potentially miss out on an appropriate treatment for medication-overuse headache. Therefore, E-diary data have become indispensable in daily practice at the Headache Clinic. “Nevertheless, we believe that treating physicians should continue to pay attention to the subjective assessment of a patient’s satisfaction during consultation” according to van Casteren.

Terwindt: “We aim for a wide implementation of the E-diary, also by other headache specialists, neurologists and general practitioners, especially since patients have reported to appreciate the E-diary. Its use improves understanding of their own disease since they are given insight in the course of symptoms over time by a weekly visual summary report.”

The multifunctional E-diary is also implemented in the large WHAT! Trial (Women, Hormones, Attacks and Treatment), investigating the effect of continuous use of contraceptive pills in women with migraine. “We have developed a flexible E-diary, which enables us to easily implement new research questions in the future” according to Verhagen. More information about women and migraine can be found at www.whatstudy.nl .

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