Briefly, daily diary

entries included 11 questions and an optional comment section. The first question asked “Did you have a headache today?” Questions 2 to 7 mirror PedMIDAS questions[5] but were modified ABC294640 datasheet to address disability for each daily diary entry. Questions 2 to 4 addressed missing school (Q2), missing partial school days due to leaving early or arriving late (Q3), and functioning at less than half ability in school (Q4) because of a headache. Question 5 asked if activities at home such as homework or chores were affected by headache. Questions 6 and 7 addressed missed participation in social or recreational activities (Q6) and functioning at less than half ability during activities because of headache (Q7). In keeping with the PedMIDAS structure, patients could not choose more than one form of disability for school or for social activities for a given headache day. For example, if Q2 (“missed school”) was selected, then Q3 and Q4 were automatically selleck blocked. Question 8 provided a headache intensity rating scale that ranged from 1 to 10. Questions 9 to 11 addressed medicine compliance. Patients were asked to complete a diary entry each day. Study

investigators had an administrative login feature that allowed review of all daily diary entries upon submission and monitoring of daily compliance. Daily e-mail reminders were sent to parents and patients when entries were missed. Families were contacted by telephone after 5 consecutive missed days. Patients were asked to complete all missed entries by describing headache disability and intensity in the comment section of the subsequent entry or by relaying information to the study coordinator by e-mail or telephone. A disability score was calculated for each headache day. The score ranged from 0 to 3 based on the sum of affirmative responses to three PedMIDAS disability categories: school

(Q2-Q4); home activities (Q5); and leisure/recreational activities (Q6-Q7). Patients distinguished school days from weekends and holidays when answering school-related questions (ie, Did you miss school today because of a headache?) Astemizole as “yes,” “no,” or “weekend or school holiday.” Weekend and holiday designations were confirmed by comparing the date-stamped diary entry to the school-district calendar. The school year was defined as all school days (including weekends and school holidays) beginning from the first school day through the last school day of the calendar year. The summer holiday comprised all calendar days not included in the school year. To assess the evidence for systematic differences in headache disability, intensity, and frequency, we tested the null hypothesis of no difference between means for school days vs non-school days and for the school year vs the summer holiday. The 90-day observation period contained weekdays during the school year, weekends during the school year, and (for n = 32 patients) days during the summer holiday.