• Kati Toom, Aire Raidvee, and Mark Braschinsky.
• Neurology Clinic, Tartu University Hospital, Tartu, Estonia. kati.toom@kliinikum.ee.
• J Headache Pain. 2020 Jun 1; 21 (1): 60.

BackgroundEpidemiological research of headache is vital but resource consuming prerequisite for evidence-based development in the field. Rapid evolution of information technology may provide new opportunities for population-based surveys. The aim of this study was to evaluate the applicability of web-based solutions in epidemiological studies of primary headaches.MethodsAn online survey was conducted among 20-64 year old Estonian citizens, using a previously validated headache questionnaire. The participants were accessed through most popular portals and e-mail domains to get the maximum coverage of Estonian digital community. The resulting one-year headache prevalences were compared to those acquired in parallel from a population-based cross-sectional person-to-person study in Estonia.ResultsFive thousand seven hundred eight entries were made by 5347 participants in the online study. Of the participants, 3896 (72.9%) had no headache, 1436 (26.8%) had only one and 15 (0.3%) had more than one type of headache. The study sample demographics were statistically significantly different from Estonian population and the prevalences were adjusted by age, gender, education and habitat. The proportion of headache sufferers was smaller in the online study sample (23.1% vs 41.0% in the population-based parallel person-to-person study). Among the headache sufferers the proportions of different headache diagnoses were similar across the two studies with the exceptions of episodic migraine and episodic tension-type headache. There were less migraine and more tension-type headache sufferers in the online study sample.DiscussionThis is the first study addressing applicability of web-based solutions in headache related large epidemiological studies. Online approach presents a much faster means of data collection, larger samples, has mechanisms of avoiding data contamination and distinguishes the proportions of most primary headache disorders among the headache sufferers. However, the present online survey was significantly biased towards the people without headache, leading to underestimation of headache prevalence. This stems from the shortcomings related to method of sampling, access and engagement.ConclusionOnline headache epidemiology research could be a resource saving alternative to person-to-person studies, however, further research is needed to overcome the problems related to methods of sampling, access and engagement.

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