A Self-Administered Screener for Migraine in Primary Care: The ID Migraine Validation Study

Neurology. 2003 Aug 12;61(3):375-82. doi: 10.1212/01.wnl.0000078940.53438.83.

Abstract

Background: Migraine is a highly prevalent and disabling illness that remains substantially undiagnosed in primary care. Because of the potential value of a screening tool, the current study was designed to establish the validity and reliability of a brief, self-administered migraine screener in patients with headache complaints in the primary care setting.

Methods: A total of 563 patients presenting for routine primary care appointments and reporting headaches in the past 3 months completed a self-administered migraine screener. All patients were then referred for an independent diagnostic evaluation by a headache expert, of whom 451 (80%) completed a full evaluation. Migraine diagnosis was assigned based on International Headache Society criteria after completing a semi-structured diagnostic interview.

Results: Of nine diagnostic screening questions, a three-item subset of disability, nausea, and sensitivity to light provided optimum performance, with a sensitivity of 0.81 (95% CI, 0.77 to 0.85), a specificity of 0.75 (95% CI, 0.64 to 0.84), and positive predictive value of 0.93 (95% CI, 89.9 to 95.8). Test-retest reliability was good, with a kappa of 0.68 (95% CI, 0.54 to 0.82). The sensitivity and specificity of the three-item migraine screener was similar regardless of sex, age, presence of other comorbid headaches, or previous diagnostic status.

Conclusions: The three-item ID Migraine migraine screener was found to be a valid and reliable screening instrument for migraine headaches. Its ease of use and operating characteristics suggest that it could significantly improve migraine recognition in primary care.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Interviews as Topic
  • Likelihood Functions
  • Logistic Models
  • Male
  • Mass Screening / methods*
  • Mass Screening / standards
  • Middle Aged
  • Migraine Disorders / diagnosis*
  • Patient Participation / methods*
  • Predictive Value of Tests
  • Primary Health Care / methods*
  • Quality of Life
  • Referral and Consultation / statistics & numerical data
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surveys and Questionnaires / standards*
  • United States