Self-Administered Screener Found Highly Reliable in Detecting Migraine

Newswise — A simple three-question test, called ID Migraine TM, can identify patients with migraine with about the same accuracy as widely used screening tests for other illnesses. It was developed by a team of migraine researchers and validated in a national study. The results appear in the current issue of Neurology, the journal of the American Academy of Neurology.

The authors report that answering "yes" to two out of three simple questions effectively identifies migraine sufferers. The questions were:

* Has a headache limited your activities for a day or more in the last three months?* Are you nauseated or sick to your stomach when you have a headache?* Does light bother you when you have a headache? According to the lead author, Richard B. Lipton, M.D. Professor and Vice Chair of Neurology at the Albert Einstein College of Medicine, ID Migraine should be used in a primary care setting, where many patients with migraine may go undiagnosed. About 28 million Americans are estimated to suffer from migraine, but less than half have ever been diagnosed by a doctor, and may be frustrated because they can't find effective treatment.

"Despite the high prevalence of migraine and its associated pain and disability, diagnostic rates for migraine remain low," Dr. Lipton said. "ID Migraine is very easy to use for both patients and doctors and we hope it will prompt patients to talk to their primary care doctor to get diagnosed and to receive treatments that will relieve their pain and improve their ability to function."

The authors tested the validity and reliability of ID Migraine at 27 primary care sites and 12 headache specialty practice sites in the U.S. A nine-question survey was completed by 443 patients making routine primary care physician visits for any reason. Patients in the study either had headaches that interfered with their ability to work, study, or their enjoyment of life; or said they wanted to talk to their physicians about their headaches. All the patients were then referred to one of 12 headache specialty centers, where specialists diagnosed them without knowing how they had answered the questionnaire. The patients' medical diagnoses were compared to the answers given to the questionnaires. An analysis identified the three questions that best predicted a migraine diagnosis; of patients who answered "yes" to two of the three questions, 93 percent were diagnosed by the headache experts as suffering from migraines.

"Because patients with migraine often present in the primary care setting, the hope is that ID Migraine will help primary care doctors identify migraine quickly and easily," Dr. Lipton said. "Given the availability of effective treatment, use of the screening tool might represent an important step toward reducing the burden of this illness."

"Headaches sometimes have serious causes not identified by the screener. Whether a patient has migraine or headaches due to other conditions, the ID migraine screener can help facilitate patient physician communication and the exchange of important information," Dr. Lipton added.

Co-authors of the paper were: K. Kolodner, D. Dodick, R. Sadovsky, J. Endicott, J. Hettiarachchi and W. Harrison. The study was supported by funding from Pfizer Inc.

Migraine is more common than diabetes (16 million) and asthma (10.6 million). It is more prevalent in women: almost one in five women and one in 15 men suffer from migraine. The prevalence of migraine peaks at approximately 40 years of age, making it most common during the peak productive years of 25 to 55.

Fifty percent of individuals reported in one study that during their migraine attacks, they experience severe functional impairment and may require complete bed rest. The impairment and impact on health-related quality of life of migraine is substantial, equivalent to or greater than other chronic medical illnesses such as angina, diabetes, and hypertension. The economic impact of migraine is also substantial, with the annual cost to employers, in terms of reduced productivity and days missed from work, estimated at more than $13 billion, and annual medical costs that exceed $2 billion. The World Health Organization (WHO) ranks migraine among the world's top 20 most disabling medical illnesses.

Abstract and article are available at http://www.neurology.org.