The aim was to evaluate the test-retest reliability of the French translation of the Migraine Disability Assessment (MIDAS) and Headache Impact Test (HIT)-6 questionnaires as applied to episodic and chronic headaches and to assess the correlation between these two questionnaires. The MIDAS and HIT-6 questionnaires, which assess the degree of migraine-related functional disability, are widely used in headache treatment clinics. The French translation has not been checked for test-retest reliability. MIDAS involves recall, over the previous 3 months, of the number of days with functional disability with regard to work and to home and social life. HIT-6 involves a more subjective and general assessment of headache-related disability over the previous 4 weeks. We expect that there may be greater impact recall bias for chronic headaches than for episodic headaches and considered it important to be able to determine if the reliability of these questionnaires is equally good for these two patient populations. Given that both questionnaires have the same objective, that of assessing headache impact, it was thought useful to determine if their results might show a correlation and if they could thus be used interchangeably. The study was approved by an external ethics committee. The subjects were patients who regularly visit the Clinique de la Migraine de Montréal, which specializes in the treatment of headaches. The MIDAS and HIT-6 questionnaires were completed by the patients during their regular visit. Twelve days later, the same questionnaires were mailed with a prepaid return envelope. Sixty-five patients were required in both the episodic and chronic headache groups, assuming an 80% questionnaire return rate. One hundred and eighty-five patients were enrolled, and 143 completed the study, 75 with episodic headaches and 68 with chronic headaches. The questionnaire return rate was 78.9%. On average, questionnaires were completed a second time 21 days after the first, with a median of 19 days. The Shrout-Fleiss intraclass correlation coefficients for MIDAS and HIT-6 were, respectively, 0.76 and 0.77 for episodic headaches and 0.83 and 0.80 for chronic headaches. The Pearson correlation coefficient between the MIDAS and HIT-6 questionnaires was 0.48 for episodic headaches and 0.58 for chronic headaches at the first compilation and 0.42 and 0.59 at the second compilation. The test-retest intraclass correlation of the French versions for both MIDAS and HIT-6 questionnaires indicates moderate reliability for episodic headache and substantial reliability for chronic headache. The correlation between the MIDAS and HIT-6 questionnaires is weak for episodic headaches, but approaches a level of 'good' for chronic headaches.
comparison cohort (patients without a COPD diagnosis) was created for patients of the same age, gender, race, index year, and baseline Charlson Comorbidity Index score as patients in the COPD cohort. To reduce selection bias, a random index date was chosen for the comparison cohort. Patients were required to have continuous medical and pharmacy benefits 1 year pre-and post-index date. One-to-one propensity score matching (PSM) was performed to compare follow-up health care costs and utilization between the cohorts, adjusting for demographic and clinical characteristics. Results: Eligible patients (N= 925,970) were identified for the COPD and comparison cohorts. After 1:1 PSM, a total of 308,089 patients were matched from each cohort and baseline characteristics were well-balanced. COPD patients had a higher percentage of health care resource utilization, including inpatient visits (12.04% vs. 2.83%, p< 0.0001); outpatient visits (99.72% vs. 77.43%, p< 0.0001); and pharmacy visits (91.35% vs. 68.37%, p< 0.0001) than non-COPD patients. Higher health care resource utilization translated to higher costs for COPD patients, including inpatient
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