Der Schmerz
-
Cluster headache is a severe primary headache disorder, which can be associated with a substantial impairment for sufferers. The Cluster Headache Impact Questionnaire (CHIQ) is a short questionnaire for measuring the cluster headache-specific impairment. A 5-stage severity grading from "no to low impairment" to "'extreme impairment" was established based on the results of an English-speaking patient collective. ⋯ Interestingly, 32 out of 52 patients with episodic cluster headache outside the active epísode suffered an impairment above the lowest severity grade, i.e., at least a moderate impairment. In conclusion, the CHIQ provides a short instrument to document the current impairment in cluster headache patients. The severity grading classification presented here facilitates the clinical interpretation.
-
The spontaneous reporting system for cases of suspected side effects is a central instrument for detecting possible side effects after a pharmaceutical preparation has received marketing authorization. It provides important information (signals) on the occurrence of rare, previously unknown side effects, on increases in the frequency of known side effects that may also be due to quality defects, or on changes in the type or severity of known side effects. In recent decades, this system has made a significant contribution to the identification of drug-related risks that only arise upon widespread use following approval and to the introduction of appropriate measures to minimize risk.
-
In addition to the usual evaluation approach (usually a clinical randomized trial in the sense of the question: does an intervention work), complex interventions require further systematic investigations to prove their effectiveness. The role of the context in which the intervention is delivered is essential here, as is consideration of the question of why an intervention works (or does not work). ⋯ In an effectiveness model, concrete, verifiable assumptions are formulated as to how an intervention produces changes that are reflected in the endpoint. This article provides a brief introduction to methodological approaches to effectiveness research on complex interventions and uses the PAIN 2.0 project (01NVF20023) to describe in concrete terms what an effectiveness model for interdisciplinary multimodal pain therapy for the prevention of chronic pain in an outpatient setting might look like.
-
Complex regional pain syndrome (CRPS) is a severe pain disorder with an unclear pathophysiology. Biomarkers offer opportunities to enhance diagnosis, stratification, prognosis, and monitoring. Serum markers such as cytokines and microRNAs show potential but require further research. ⋯ Psychosocial factors, including pain intensity and psychological comorbidities, are important prognostic indicators. Future research should focus on specific biomarkers to develop mechanism-based treatments. A multidisciplinary approach remains crucial for effective treatment.