{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:11:46Z","timestamp":1781759506815,"version":"3.54.5"},"reference-count":56,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2024,11]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Describe the epidemiology of cluster headache (CH) using Veterans Health Administration (VHA) Electronic Health Record (EHR) data.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Epidemiologic studies of CH at the population level are difficult because it has a prevalence of ~0.1%. Hospital system\u2010wide studies are an attractive alternative as they have large numbers of patients and broader populations than headache or neurology clinic\u2010based studies. The VHA is an ideal hospital\u2010based system in which to study CH because it is nationwide, predominantly male, has a strong focus on mood disorders and suicidality, and has accessible individual medical records. Here, we report the first headache study based on an ongoing longitudinal cohort of patients with CH using VHA EHR data.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The VHA EHR data were accessed from Fiscal Year 2008 to 2019. Patients with CH consisted of all patients with at least one outpatient visit containing a CH diagnosis code from the International Classification of Diseases (ICD)\u20109 or \u201010. We extracted data on demographic features, incidence, and prevalence, as well as pain and psychiatric comorbidities.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 1,524,960 distinct patients who presented for headache treatment in the VHA between Fiscal Year 2008\u20132019, 24,131 had at least one visit with a CH diagnosis. The 1\u2010year period prevalence of a CH diagnosis in the VHA ranges from 0.08% to 0.10% for women and 0.10% to 0.18% for men. A larger proportion of women versus men received a diagnosis of unspecified CH (59.6% [1412\/2368] vs. 53.6% [11,663\/21,763],\n p<\/jats:italic>\n \u2009<\u20090.001). Most patients with CH had both comorbid headache and non\u2010headache pain diagnoses. Headache not\u2010otherwise\u2010specified was the most common comorbid headache disorder at 70.0% (16,885\/24,131) and was more common in women (76.1%, 1801\/2368) compared to men (69.3%, 15,084\/21,763). Other common comorbidities included migraine, depression, tobacco use, and obstructive sleep apnea. Rates of suicidal ideation or attempt were almost 50% higher in women (5\u2010year proportion 9.4%, 222\/2368) with CH compared to men (6.6%, 1433\/21,763).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n To our knowledge this is the largest hospital system study of CH to date and reinforces several previous studies. Pain, mental health, and sleep disorders comorbidities are particularly prevalent in this group and were often more common in women compared to men with CH. Future work should examine gender and race stratified prevalence estimates within the VHA and other healthcare systems.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/head.14842","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T08:49:28Z","timestamp":1728895768000},"page":"1273-1284","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Characteristics of men and women with medically diagnosed cluster headache in a national integrated healthcare system: A Veterans Health Administration cohort study"],"prefix":"10.1111","volume":"64","author":[{"given":"Elizabeth K.","family":"Seng","sequence":"first","affiliation":[{"name":"Veterans Affairs Headache Centers of Excellence Research Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH) West Haven Connecticut USA"},{"name":"Ferkauf Graduate School of Psychology Yeshiva University Bronx New York USA"},{"name":"Saul R. Korey Department Neurology Albert Einstein College of Medicine Bronx New York USA"},{"name":"Montefiore Medical Center Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Burish","sequence":"additional","affiliation":[{"name":"UT Health Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda T.","family":"Fenton","sequence":"additional","affiliation":[{"name":"Veterans Affairs Headache Centers of Excellence Research Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH) West Haven Connecticut USA"},{"name":"Department of Neurology Yale University School of Medicine New Haven Connecticut USA"},{"name":"Yale School of Public Health New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle A. D.","family":"Schindler","sequence":"additional","affiliation":[{"name":"Veterans Affairs Headache Centers of Excellence Research Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH) West Haven Connecticut USA"},{"name":"Department of Neurology Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Veterans Affairs Headache Centers of Excellence Research Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH) West Haven Connecticut USA"},{"name":"Yale School of Public Health New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manali A.","family":"Phadke","sequence":"additional","affiliation":[{"name":"Veterans Affairs Headache Centers of Excellence Research Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH) West Haven Connecticut USA"},{"name":"Yale School of Public Health New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Skanderson","sequence":"additional","affiliation":[{"name":"Veterans Affairs Headache Centers of Excellence Research Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH) West Haven Connecticut USA"},{"name":"Yale School of Public Health New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Best","sequence":"additional","affiliation":[{"name":"Veterans Affairs Headache Centers of Excellence Research Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH) West Haven Connecticut USA"},{"name":"Ferkauf Graduate School of Psychology Yeshiva University Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2652-2897","authenticated-orcid":false,"given":"Richard B.","family":"Lipton","sequence":"additional","affiliation":[{"name":"Saul R. Korey Department Neurology Albert Einstein College of Medicine Bronx New York USA"},{"name":"Montefiore Medical Center Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason J.","family":"Sico","sequence":"additional","affiliation":[{"name":"Veterans Affairs Headache Centers of Excellence Research Education, Evaluation, Engagement Center Activities Center for Headache (RE3ACH) West Haven Connecticut USA"},{"name":"Department of Neurology Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/j.1468-2982.2008.01592.x","article-title":"The incidence and prevalence of cluster headache: a meta\u2010analysis of population\u2010based studies","volume":"28","author":"Fischera 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