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Simple screen accurately identifies migraine. (For Use in Primary Care Setting).
HONOLULU -- A positive response on two out of three questions provides a simple yet powerful way to identify migraine headaches in the primary care setting, Dr. David W. Dodick reported at the annual meeting of the American Academy of Neurology.
A positive response on any two of the three questions (see box) yields a sensitivity of 81%, a specificity of 75%, and a positive predictive value of 93% for the diagnosis of migraine. A positive response to all three questions yields a positive predictive value of 98%, said Dr. Dodick of the Mayo Clinic, Scottsdale, Ariz.
"Improving migraine recognition in primary care is obviously a key step to improving outcomes," Dr. Dodick said. "The overwhelming majority of migraine sufferers seek their headache care in the primary care setting and usually remain in the primary care setting."
Previous studies have shown, however, that the majority of migraine sufferers never receive a migraine diagnosis. The most common misdiagnoses are sinus headache, stress or tension headache, and headache not otherwise specified.
Dr. Dodick and his colleagues arrived at the three questions by asking patients presenting with headache to 1 of 27 primary care sites around the country to complete a questionnaire. The questionnaire consisted of nine items based on International Headache Society criteria.
The patients were asked four questions about the type of pain: unilateral; pounding, pulsating, or throbbing; moderate to severe; and exacerbated with routine physical activity. They were questioned on four types of associated symptoms: nausea, aura, photophobia, and phonophobia, and were asked one question about disability.
The patients were 18-55 years old and reported having had two or more headaches in the past 3 months. They also said either that they wanted to talk to a headache specialist or that ...
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Source: HighBeam Research, Simple screen accurately identifies migraine. (For Use in Primary...