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Kephale

Reading the Kephale report

A patient-recorded headache diary, summarised on A4. Page one answers the main questions; details follow. The report records; it does not diagnose.

Recorded by the patient in a migraine diary. Not a medical record and not a diagnosis. The same line is printed at the foot of every page.

Sections, in report order

  1. Header. Period, dates, the compiled date, and the patient's name and photo. The compiled date shows which snapshot of the diary this is. Name and photo are optional; without them, a blank line is left for the name.
  2. Contents. Sections and page numbers.
  3. Headache days per month. Month, headache days, acute medication days and attacks. A headache day is any calendar day touched by a recorded attack: one attack lasting two days counts as two headache days. Attacks are counted in the month they started. Months cut by the report period, or not over yet, are marked as partly observed ("X of Y days observed") and never flagged as reaching a threshold.
  4. Findings. One line each: preventive medication, medications for attacks with the number of days, the most frequent trigger ("n of N attacks") and sleep. Each figure is repeated with its basis further on.
  5. Totals. Headache days, attacks, mean and worst pain, medication days, total time, and the share of attacks with intensity recorded. Mean pain is calculated only over attacks where intensity was recorded; the share is printed next to it.
  6. Attack patterns. Attacks over time, a pain calendar, pain levels, duration bands, part of day, weekday, pain against duration, and headache days per month. In the pain calendar, darker means more pain, in one hue that stays readable in black-and-white print. "Not recorded" marks an attack without an intensity. Duration bands also run from light to dark: longer is darker.
  7. Triggers and symptoms. Triggers, symptoms and what helped. Counts are attacks where the patient marked the item, out of all attacks in the period. Co-occurrence, not cause.
  8. Weather. The change in barometric pressure over the 24 hours before each attack. Shown only for attacks recorded with weather on. The 5 hPa boundary is a display convention, not a medical threshold.
  9. Sleep. Sleep duration and bedtime before attacks, compared with other nights. Read from Apple Health with the patient's permission. Appears only after enough nights; otherwise the card states how many are missing.
  10. Cycle. How attacks line up with menstruation days. Included only on the patient's explicit choice.
  11. Medications and effectiveness. Medication classes, days of use for each, effectiveness from the patient's "Did it work?" answers, and medication days per month against thresholds. Medications from the patient's list are printed under international non-proprietary names.
  12. Attack log. By month, newest first: time, duration, intensity, and medications with doses. Listed last on purpose: patterns first, individual attacks when something stands out.

Scales and definitions

  • Pain scale. Self-rated from 1 to 10, in four bands: Slight 1–2, Mild 3–4, Moderate 5–7, Severe 8–10. Zero is not recorded.
  • Headache day. Any calendar day touched by a recorded attack.
  • Attack. One recorded episode, from start to end, counted in the month it started.
  • Acute medication day. A day with at least one recorded dose of a medication for attacks; preventives and antiemetics are not counted. Days, not tablets: headache guidelines count medication use in days.
  • Guideline thresholds. As printed in the report: "Headache guidelines use 15 headache days a month, and 10 days of acute medication for triptans and combinations or 15 for simple painkillers. The diary counts days and makes no diagnosis." No threshold is applied to antiemetics, preventives or other classes. A reached threshold is shown in amber, not red: a point for discussion, not an alarm.
  • The 15-day figure comes from the ICHD-3 criteria. The report shows only the count of days; the second part of the criterion (more than three months) is not checked.

Limits of the data

  • Self-reported. Entries depend on the patient remembering to log.
  • Gaps are shown, not hidden: partly observed months and the share of attacks with intensity are printed.
  • Sleep and cycle come from Apple Health and appear only with the patient's permission.
  • Free text is printed as the patient typed it, in the patient's language.

Report language

The report can be compiled in a different language from the app's, in any of the 39 supported languages.

Contact

Questions about the report format: support@kephale.app.

Medical disclaimer

Kephale is a personal diary for recording headaches and migraine attacks. It is not a medical device and is not intended to diagnose, treat, cure, prevent or predict any disease. Figures in the app and in reports are counts of what the user recorded. Thresholds shown come from published headache guidelines and are displayed for reference only. Always seek the advice of a qualified health professional with any questions about a medical condition. If you think you may have a medical emergency, call your local emergency number.