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Permanent link (DOI): https://doi.org/10.7939/R3FM6C

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Practice Variation in the Treatment of Children with Migraine in the Emergency Department Open Access

Descriptions

Other title
Subject/Keyword
emergency department
placebo response
migraine
practice variation
systematic review
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Richer, Lawrence
Supervisor and department
Rowe, Brian (Emergency Medicine)
Examining committee member and department
Klassen, Terry (Pediatrics)
Sevcik, Bill (Emergency Medicine)
Spady, Don (Pediatrics)
Department
School of Public Health
Specialization

Date accepted
2009-10-02T21:52:23Z
Graduation date
2009-11
Degree
Master of Science
Degree level
Master's
Abstract
This thesis presents the results of three studies examining the management of migraine in children. First we conducted a systematic review of all clinical trials conducted in children and adolescents of the acute migraine therapy. A meta-analysis of the 26 randomized controlled trials is presented. A single trial with a focus on Emergency Department (ED) management was identified. As such, we then examined current ED practice in two retrospective practice variation studies. The first compared four regional hospital EDs where practice patterns were significantly different between mixed population EDs (both adult and pediatric patients) and the tertiary pediatric ED. The second examined practice variation among ten tertiary pediatric EDs in Canada where significant differences were again observed. Factors that influenced the choice of medications included increasing patient age and the physician’s diagnosis of migraine. Important areas of future investigation include: (1) the effectiveness of intravenous fluids alone; and (2) the use of combined medications.
Language
English
DOI
doi:10.7939/R3FM6C
Rights
License granted by Lawrence Richer (lricher@ualberta.ca) on 2009-10-01T03:47:30Z (GMT): Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of the above terms. The author reserves all other publication and other rights in association with the copyright in the thesis, and except as herein provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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