AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2637-8892/037
Department of Pharmacology, Nagasaki, Japan.
*Corresponding Author: Agatha Christie, Department of Community Medicine, Nagasaki, Japan.
Citation: Agatha Christie, (2018) Headache Diagnosis in Enhance patient satisfaction. J.Psychology and Mental Health Care, 2(2); DOI: 10.31579/2637-8892/037
Copyright: © 2018 Agatha Christie. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 18 January 2018 | Accepted: 28 February 2018 | Published: 19 April 2018
Keywords: diagnosis; primary care; headache; migraine; chronic daily headache
Introduction: Doctors in primary care are responsible for diagnosing and managing patients with headache, but frequently lack confidence in doing so. We aimed to compare Family Practitioners’ (FPs) diagnosis of headaches to classification based on a symptom questionnaire, and to describe how classification links to other important clinical features.
Methods: This was an observational study of patients attending primary care doctors for headache.
Main outcome measures: Patients completed a questionnaire including the Headache Impact Test, the Migraine Disability Assessment Score, the Hospital Anxiety and Depression Scale, the Illness Perceptions Questionnaire, a satisfaction scale, a service use inventory and a symptom questionnaire rated by two Practitioners with Special Interest (PSIs) in Headache.
Results: 255 patients completed questionnaires. There was low agreement between FP diagnosis and classification using the symptom questionnaire. FPs frequently did not use the diagnosis migraine, when patient reported symptoms which justified this. FPs did not classify patients with ≥15 days of headache separately as chronic daily headache (CDH), and this could be because the classification system used does not have that code. Patients classified as CDH using the symptom questionnaire reported more disability, more symptoms of anxiety and depression (HADS), more service use, and less satisfaction with FP care.
Conclusion: Patients, who present with headache in primary care, tend to receive non-specific diagnoses. Having a system that would allow separate classification of people with headache of ≥ 15 days a month might help FPs to explore and address associated features with patients in terms of disability, psychological co-morbidity and cost, and improve satisfaction with care.
Headache is common and 4% of adults consult their family practitioner (FP) for headache each year, with 97% managed entirely in primary care [1]. Doctors frequently express lack of confidence in diagnosing neurological conditions, which may partially be due to lack of appropriate clinical teaching [2]. We described the characteristics of patients with headache consulting FPs, and found nearly 30% had case-levels of anxiety [3]. Reasons FPs gave for referring to neurologists included the patient’s anxiety about brain tumor, and the FP’s lack of confidence in diagnosis [4]. We previously estimated UK service costs for people consulting with headache are £956 million and the total costs including lost production are £4.8 billion [5].
Guidelines on headache classification are disputed and have changed over time [6,7]. It is not clear how classification systems designed by neurologists and academic researchers can contribute to clinicians working in primary care. Comparison of FP diagnosis with expert classification has suggested under-diagnosis of migraine and under-use of migraine-specific management [8, 9]. Common headache types seen by FPs are migraine with and without aura, episodic tension-type headache (TTH), and chronic daily headache (CDH = headache lasting on average for ≥4 hours on ≥15 days per month). Secondary (sinister) headaches and cluster headache are rare. A major strength of UK primary care has been the computerization of patient records using the Read-code system, which has more than 30 codes for the common headache and migraine diagnoses. However, Read-codes were not designed to mirror or adapt to emerging criteria produced by specialists and researchers, such as the International Headache Society (IHS) classification of headache and migraine.
We aimed to describe the diagnoses made by FPs using Read-code data (http://www.connectingforhealth.nhs.uk/systemsandservices/data/uktc/readcodes), and compare them to a classification applied on the basis of symptoms reported by patients in a questionnaire, which was rated independently by two Practitioners with Special Interest (PSI) in headache. We aimed also to describe the extent to which PSIs’ classifications were associated with other characteristics of headache consulters which may be important in management, including headache impact, disability, psychological state, service and lost-productivity costs and satisfaction with care.
Practices and Patients
Eighteen family practices, with 150 family practitioners (FPs) participated in the study. Practices were located in the South East region of the UK. The number of patients in the registered population aged 18–75 years was approximately 141,000. Eligible patients were those consulting for headache as a main or important problem. Study methods have been described in full elsewhere [3].
Study Design
To recruit patients, a designated person in each family practice identified each patient as they consulted for headache, classified according to pre-defined Read-codes. All 23 Read-codes including the word ‘headache’ were included in the search as well as all 11 including the word ‘migraine’, except for 115E = ‘no history of migraine’ unless it was accompanied by another headache Read-code. Patients identified as having consulted for headaches from the Read-code used by the FP during the consultation were invited to re-attend their practice to complete a questionnaire.
Criteria-Based Classification
Criteria were developed for this study based upon the IHS I (1998) guidelines [6]; with additional items from the Silberstein-Lipton criteria [10]. All patients completed a symptom questionnaire at their assessment, and patients could report up to three different headaches. Two PSIs independently rated questionnaire responses, allocating patients to classification groups depending on their headache symptoms, and assigning an overall classification where more than one headache was reported. The PSIs were blind to the Read-code recorded by the patient’s FP. Using this method, patients were classified as having migraine with and without aura, headache on ≥ 15 days a month classified as chronic daily headache (CDH) with and without analgesic dependence, and ‘other’ headaches. The two PSI met to discuss their decisions when ratings differed. A migraine classification required two or more out of four of the following symptoms:- one sided, throbbing, worse with exertion, moderate of severe, plus one or more of nausea, photophobia, and phonophobia.
Measures of Patients’ Characteristics
Patients’ clinical characteristics were assessed using a self-report booklet of validated questionnaires including the Headache Impact Test (HIT-6), a valid and reliable six-item questionnaire designed to assess the impact headaches have on ability to function in the previous month [11], and the Migraine Disability Assessment Score (MIDAS), a valid and reliable five-item questionnaire requiring responses to five questions about disability associated with headache in the previous 3 months [12]. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS), a valid and reliable 14-item self-report scale which has been widely used in community samples [13]. Patients were asked to report which of a list of 26 symptoms they experienced and considered to be connected with their headaches, which is part of the Illness Perceptions Questionnaire (IPQ-R) [14]. Patient satisfaction with treatment provided by their family practice was measured using one item from a reliable questionnaire developed for use in primary care [15]. Patients were asked to agree if they were satisfied and the 5-point Likert scale was anchored at 1 = strongly disagree and 5 = strongly agree. This scale was then dichotomized to disagree (1–3) and agree (4–5). Research associates collected information on the FPs’ diagnosis and consultation frequency in the previous 3 months.
The services included were: contacts with FPs, neurologists, other medical specialists, contacts with other professionals (including complementary healthcare), scans undertaken (MRIs and CTs), and prescribed medication. For scans and FP contacts we asked about the number of times these had been received for headache and how many for other reasons. Unit costs were attached to the information on service use using nationally applicable figures [16]..The economic cost of lost work time was calculated by multiplying the lost days by the earnings that patients in the sample received (calculated as a daily figure). Not all patients stated their earnings and in these cases we obtained average figures for their job type and gender from official data [17].
Data Analysis
Data were analysed using SPSS version 8. Data were analysed using non-parametric tests for categorical variables, and with t-tests for continuous data where differences were compared between diagnostic groups. Statistical methods are described in details elsewhere [18].
Results
FPs’ diagnosis from Read-codes
of the 34 Read-codes available, nine were used by the FPs in this study, and we combined these codes, so that only the stem diagnosis was used. Of 255 patients, FPs classified 80 (31%) patients as having migraine (FP-migraine) and 144 (57%) as headache (FP-other headache), 23 (9%) tension headache, and for the remaining 8 (3%), headache was not classifiable.
PSIs’ criteria-based classification
Using the criteria-based classification, 163/255 patients (63.9%) reported experiencing a single type of headache, and 92 patients (36.1%) experienced two or three different types of headaches. Ten patients (4%) did not provide enough information for a classification. Where there was more than one type of headache reported, the higher category in terms of severity was applied. Using this strategy 152 (60%) patients were classified as migraine, 78 (31%) were classified as CDH, and the remaining 15 (6%) were classified in less common diagnostic groups, and subsequently excluded from further analysis.
FP Read-code diagnosis compared to PSI criteria-based classification
Table 1 shows that for migraine, there was agreement between the FPs’ diagnosis and the PSI criteria-based classification in 55 cases (37% of 147 classified as migraine by PSIs). A further 92 (63%) cases which were classified as migraine using the criteria, were diagnosed as other types of headache by FPs (84 other headache and eight tension headache). FPs did not have a code with which to identify people with headaches on ≥ 15 days per month (CDH), and classified 45/76 (59%) as headache, and 17/76 (22%) patients as having migraine.
Table 1: Comparison between FPs’ diagnosis and criteria-based classification
Association of criteria-based classification with other patient characteristics
Table 2 compares the criteria-based classification of patients with migraine and CDH (≥15 days month). Compared to migraine, the CDH group had significantly more headache-related disability, significantly higher scores for anxiety and depression, and were more likely to be dissatisfied with the treatment received from their FP. Compared to migraine, the group with CDH had significantly higher service costs (migraine £115 (sd £156), CDH £164 (sd £194), bootstrapped 95% CI of difference £4 to £97). Compared to migraine, the group with CDH had significantly higher total costs (migraine £475 (sd £1007), CDH £797 (sd £1438), bootstrapped 95% CI of difference £6 to £680).
Summary of main findings
Compared to PSI’s, FPs appear to underdiagnose migraine. As there were no codes for Chronic Daily Headache (CDH), FPs could not classify headaches in the same way as the PSI. Comparison between patients with migraine and CDH, showed that the group with CDH, reported more disability, more symptoms of anxiety and depression, higher costs and lower satisfaction with care.
Strengths and the limitations of this study
The study has compared a diagnosis recorded by a FP (with the patient present but with the limitations of time and the coding scheme), with classification made by practitioners with extra training and experiences (PSIs) who had access to and used responses to a symptom questionnaire. PSI having access and scoring a symptom questionnaire is clearly a different process from the clinical consultation, which can take account of other features, including FP not having special training, having limited time, and working with a coding scheme which is not designed to be consistent with criteria produced by specialists for academic research. It is possible that FPs gave their patients the optimal treatment irrespective of the Read-code used, assessing this was not the purpose of the study. However, interviews with a sample of the FPs in this study found that lack of clinician confidence and patient pressure were factors which influenced FPs in deciding to refer patients to specialists [4].
Relationship to other studies
In another family practice study, Weindels et al found that compared to patients with less frequent headache episodes, a group with frequent headaches (≥15 days per month) were significantly more likely to have somatic problems, like gastroenterological and musculoskeletal disorders [18], as well as more psychiatric disorders and medication over-use [19]. Both frequent headache and co-morbidity were associated with lower quality of life [19]. Compared to hospital specialists, FPs potentially have more information about patients’ other conditions and their management as a whole. However current diagnostic classification using the Read coding system does not make necessarily alert FPs to linking headache diagnosis with this other clinical information. In this context it is possible that psychological co-morbidity is under-diagnosed or not connected. Prescription of pain medication for headache and co-morbid conditions may contribute to a vicious cycle, with headache and pain symptoms becoming frequent and chronic. Our evidence may increase FPs awareness of frequent headache, and its co-morbidity, and stimulate FPs to identify and manage the co-morbidities of these patients more precisely.
Implications for clinical practice and research
Our results suggest that FPs underuse migraine as a diagnosis. Previous findings suggest that when patients describe a few episodes of headache, they may not include symptoms like unilateral, pulsating pain, or think they have tension headache, and their doctors may not diagnose migraine [12]. Symptom diaries and questionnaires produce a longitudinal picture. FPs does not have a Read-code for CDH, and have more problems managing patients with CDH, because of associated co-morbidity. When we previously analysed and reported the quantitative data, in which this qualitative study was nested, we found a third of patients presenting in family practice were classified as chronic [3].However when one of us described referrals to a headache clinic, two-thirds had CDH [20]. It is possible that failure to identify and address the disability, psychological morbidity and cost which can be associated with CDH may lead to dissatisfaction among some patients, who then apply pressure for referral to specialists. The read codes need a revision to include CDH because not having this code available limits the FP physician’s ability to properly classify patients. If FPs are able to distinguish low from high frequency headache, this may help them to identify and manage the associated disability, psychological co-morbidity and cost associated with headache. Addressing these issues in primary care may have health gains for patients, enhance patient satisfaction, reduce referral, and reduce costs for patients and society [5]. This remains to be evaluated.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
