title: What efficacy measures are clinically relevant and should be used in Cochrane reviews of acute migraine trials? An alternative viewpoint.
abstract: I briefly review the purposes of efficacy measures, which go far beyond supporting new drug development. I use vignettes to illustrate the importance of functional recovery during the migraine attack, and argue that headache relief provides this. Sustained headache relief (SHR) is therefore a very worthwhile outcome when the alternative is a day of debilitating pain. As a measure, SHR may not be ideal for new drug development but it is informative to individuals, health care providers and politicians, and serves cost-effectiveness analysis better than any other. Cochrane are absolutely right to use it in systematic reviews along with the IHS-recommended measures.
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Norway Division of Brain Sciences, Imperial College London, UK t.steiner@imperial.ac.uk.
authors.forename: T J
authors.initials: TJ
authors.lastname: Steiner
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care / Q000592:standards*; D012196:Review Literature as Topic
keywords: Cochrane Collaboration; Migraine; acute treatment; clinical trials; efficacy measures