Staging headache cases: reconciling the complexity of a case with the required intensity of treatment

To stage a chronic illness is to place the case along a continuum of illness progression and complexity. Staging can also identify key clinical variables and treatment targets in order to assure the most effective treatment, as well as providing the basis for measuring illness progression and improvement. Underlying an effective staging concept is the principle that to achieve clinically effective outcomes and maximal cost effectiveness, the severity and complexity of a case must be matched to the most appropriate level and intensity of care. With the growing appreciation that the primary headache disorders represent a major public health problem and the increasing need to assure the most cost effective and clinically effective care, the authors believe that the time to implement a formal staging concept for primary headaches is now upon us.