@article{ref1,
title="Development and validation of a model predicting post-traumatic headache six months after a motor vehicle collision in adults",
journal="Accident analysis and prevention",
year="2020",
author="Cassidy, J. David and Salmi, Louis-Rachid and Holm, Lena W. and Côté, Pierre and Boyle, Eleanor and Cancelliere, Carol",
volume="142",
number="",
pages="e105580-e105580",
abstract="IMPORTANCE: The prognosis of post-traumatic headache is poorly understood.  OBJECTIVE: To develop and validate a prognostic model to predict the presence of post-traumatic headache six months after a traffic collision in adults with incident post-traumatic headache.  DESIGN: Secondary analyses of adults with incident post-traumatic headache injured in traffic collisions between November 1997 and December 1999 in Saskatchewan, Canada (development cohort); and between January 2004 and January 2005 in Sweden (validation cohort).  SETTING: The Saskatchewan cohort (development) was population-based (N = 4162). The Swedish cohort (validation) (N = 379) were claimants from two insurance companies covering 20 % of cars driven in Sweden in 2004.  PARTICIPANTS: All adults injured in traffic collisions who completed a baseline questionnaire within 30 days of collision. Excluded were those hospitalized >2 days, lost consciousness >30 min, or reported headache <3/10 on the numerical rating scale. Follow-up rates for both cohorts were approximately 80 %.  PREDICTORS: Baseline sociodemographic, pre-injury, and injury factors.  OUTCOME: Self-reported headache pain intensity ≥3 (numerical rating scale) six months after injury.  RESULTS: Both cohorts were predominantly female (69.7 % in Saskatchewan, 65.2 % in Sweden), with median ages 35.9 years (Saskatchewan), and 38.0 years (Sweden). Predictors were age, work status, headache pain intensity, symptoms in arms or hands, dizziness or unsteadiness, stiffness in neck, pre-existing headache, and lower recovery expectations. With a positive score (i.e., ≥0.75 probability), the model can rule in the presence of post-traumatic headache at six months (development: specificity = 99.8 %, 95 % CI 99.5 %-99.9 %; sensitivity = 1.6 %, 95 % CI 1.0 %-2.6 %; positive likelihood ratio (LR+) = 8.0, 95 % CI 2.7-24.1; negative likelihood ratio (LR-) = 1.0, 95 % CI 1.0-1.0; validation: specificity = 95.5 %, 95 % CI 91.1 %-97.8 %; sensitivity = 27.2 %, 95 % CI 20.4 %-35.2 %); LR+ = 6.0, 95 % CI 2.8-13.2; LR- = 0.8, 95 % CI 0.7-0.8).  CONCLUSIONS AND RELEVANCE: Clinicians can collect patient information on the eight predictors of our model to identify patients that will report ongoing post-traumatic headache six months after a traffic collision. Future research should focus on selecting patients at high risk of poor outcomes (using our model) for inclusion in intervention studies, and determining effective interventions for these patients.<p /> <p>Language: en</p>",
language="en",
issn="0001-4575",
doi="10.1016/j.aap.2020.105580",
url="http://dx.doi.org/10.1016/j.aap.2020.105580"
}