Understanding clinical trials in migraine

The following points are covered in this review. (1) How a randomised clinical trial in migraine is performed. The whole process from idea to publication of an article is reviewed. (2) How to understand a paper on clinical trials in migraine. The aim of the study, design of study, efficacy measures and presentation of results are reviewed. The aim of the study is often stated vaguely and it is suggested to look at the power calculations in order to understand the aim of the study. The aims and the results of the trial programmes of the triptans are reviewed. Results of the study should be presented with 95%CI. (3) How to understand meta–analyses in migraine. Relationship between meta–analyses and head–to–head comparative trials is reviewed; and it is concluded that head–to–head comparisons remain the “golden standard” with metaanalyses as a useful supplement.