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| 50th Annual Meeting of the American Headache Society |
Boston, Massachusetts June 26-29, 2008 |
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International Classification of Headache Proves
to be a Crucial Advance |
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BY MAURY M. BREECHER
Contributing Writer |
BOSTON — The international classification of
headache disorders (ICHD-1 and 2) may be the most
important advance in headache science for 50 years, said
Dr. Jes Olesen at the 50th Annual Scientific Meeting of
the American Headache Society on June 28.
“The IHS-Classification is one of the most important
global milestones in the history of headache research
for 50 years,” said Dr. Olesen of the Danish Headache
Center at the University of Copenhagen, Denmark, who is
a longtime pioneer and advocate of headache
classification.
“A group of diseases without a system of classification
is like a society without laws,” he said. “Operational
diagnostic criteria are the crucial factor for
present-day progress in headache research and therapy.”
The classification system is hierarchal, pointed out Dr.
Olesen.
“You can code up to four levels and use it at different
levels of sophistication,” he explained. “That means it
can be used in general practice, in referral centers, it
can be used for science. All you have to do is choose
the level of sophistication you want to use.”
He asked, “What if we did not classify and define
headaches?”
According to Dr. Olesen, the world would be a poorer
place because headache epidemiology and cost data would
be missing, clinical data would be limited to single
patients, and no materials could be gathered for the
study of disease mechanisms or for genetic studies, or
for trials of acute and preventive drugs.
The classification system was designed for use both by
research and clinical communities, Dr. Olsen pointed
out. ICHD-1 and 2 have been crucially important for
selecting patients for clinical trials, choosing
patients for studies of headache mechanisms, and for
encouraging the general acceptability of new treatments.
It has also been crucially important for describing
convincingly the cost and burden of migraine to society.
“The politicians now have the data they need to
recognize the terrible burden that headache places on
society,” pointed out Dr. Olesen.
The IHS classification is exhaustive, all headaches can
be classified according to its criteria.
“In addition to distinguishing the more than 100
different types of headaches, we gave precise diagnostic
criteria for all the headache entities,” said Dr. Olesen.
“We are able to diagnose headache in the same way
throughout the United States and throughout the world.”
The classification system has been endorsed by all
national headache societies, by the World Federation of
Neurology and the World Health Organization (WHO). In
fact, WHO accepted the major principles of IHS in its
ICD 10 and, in 1997, published a separate guide
containing the operational criteria of the
classification system. |
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