The validity of questionnaire-based diagnoses: the third Nord-Trøndelag Health Study 2006-2008

J Headache Pain. 2010 Feb;11(1):67-73. doi: 10.1007/s10194-009-0174-7. Epub 2009 Nov 28.


The Nord-Trøndelag Health Study (HUNT 3) performed in 2006-2008 is a replication of the cross-sectional survey from 1995 to 1997 (HUNT 2). The aim of the present study was to assess the sensitivity and specificity of questionnaire-based headache diagnoses using a personal interview by a neurologist as a gold standard. For the questionnaire-based status as headache sufferer, a sensitivity of 88%, a specificity of 86%, and a kappa statistic of 0.70 were found. Chronic headache, chronic tension-type headache (TTH), and medication overuse headache (MOH) were diagnosed with a specificity of > or =99%, and a kappa statistic of > or =0.73. Lower figures were found for the diagnoses of migraine and TTH. For individuals with headache > or =1 day per month, a sensitivity of 58% (migraine) and 96% (TTH), a specificity of 91 and 69%, and a kappa statistic of 0.54 and 0.44 were found, respectively. The specificity for migraine with aura was 95%. In conclusion, the HUNT 3-questionnaire is a valid tool for identifying headache sufferers, and diagnosing patients with chronic headache, including chronic TTH and MOH. The more moderate sensitivity for migraine and TTH makes the questionnaire-based diagnoses of migraine and TTH suboptimal for determining the prevalence. However, the high specificity of the questionnaire-based diagnosis of migraine, in particular for migraine with aura, makes the questionnaire a valid tool for diagnosing patients with migraine for genetic studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cross-Sectional Studies
  • Female
  • Headache Disorders / classification
  • Headache Disorders / diagnosis*
  • Headache Disorders / epidemiology
  • Health Surveys*
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / diagnosis
  • Norway / epidemiology
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Surveys and Questionnaires*
  • Tension-Type Headache / diagnosis
  • Tension-Type Headache / epidemiology
  • Young Adult