(October 28, 2003) Based on figures from the year 2000 United States Census, there are more than 32 million Migraineurs in the U.S. alone. Based on today's World Population Clock provided by the U.S. Census Bureau, there are 763,465,377 Migraineurs around the world (12% of the population). One of the biggest problems facing Migraineurs is being properly diagnosed.
Thus, R.B. Lipton, MD, D. Dodick, MD, R. Sadovsky, MD, K. Kolodner, PhD, J. Endicott, PhD, J. Hettiarachchi, MD and W. Harrison, MD, undertook the ID MigraineTM validation study.
Study 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."1
Study Methods:
A total of 563 patients
who went to their primary care physician for routine appointments and reported
headaches in the previous three months were asked to complete a
self-administered migraine screener. The patients were then referred for an
independent diagnostic evaluation by a headache and Migraine expert. Of those
563 patients, 451 (80%) completed a full evaluation. Migraine diagnosis was
assigned based on International Headache Society
criteria.
Results:
"The three-item ID
MigraineTM 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."1
At the
2003 Annual Meeting of the American
Neurological Association,
Dr. Roger Cady,
Director, The Headache Care Center in Springfield, Missouri, reported results in
3,014 patients with a diagnosis of Migraine who were also screened using a
simple three-question headache screening questionnaire. Of the 3,014 patients
with a diagnosis of Migraine by any of the three criteria, 76.33% were
determined to have a positive response on the Migraine screener.
The trial included men and women from 18 to 72 years of age who had been diagnosed with Migraine by their private physician. Diagnosis was established one of three ways:
- the International Headache Society (IHS) criteria for Migraine with or without aura,
- the physician's clinical impression of Migraine based on the patient's history and investigator's clinical experience, or
- the presence of recurrent disabling headaches based on the patient's report or questioning by the investigator.
The three-question Migraine screener used in the trial these simple questions:
- Do you have recurrent headaches that interfere with work, family, or social function?
- Do(es) your headache(s) last at least 4 hours untreated?
- Have you had new or different headaches in the past 6 months?
Dr. Cady commented,
"While migraine patients most often seek help from a primary care physician, these physicians often have limited time to perform a comprehensive evaluation for migraine ... Simple and effective tools are needed to assist the primary care doctor with rapid recognition of acute migraine, so that the most appropriate treatment can be offered."2
Summary:
These two studies are great news for people who may have Migraine
disease and have yet to be diagnosed. An easier, more efficient method of
diagnosis means earlier treatment and earlier referral to a neurologist or
Migraine specialist, if necessary. It's not 100% accurate, but no diagnostic
tool is. Since there is no definitive diagnostic test for Migraine, the Migraine
Screener will be an invaluable tool.
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Resources:
1 R.B. Lipton, MD, D. Dodick, MD, R. Sadovsky, MD, K. Kolodner, PhD, J. Endicott, PhD, J. Hettiarachchi, MD and W. Harrison, MD. (2003). "A self-administered screener for migraine in primary care."Neurology 2003;61:375-382.
2 Stein, Jill. "ANA: Three-Question Headache Screening Test Can Diagnose Migraines." Doctor's Guide. October 24, 2003.
