Development and validation of an Arabic-language headache questionnaire for population-based surveys

Abstract

BackgroundThe reported prevalence of headache disorders in Arab regions varies considerably between countries. This may be due to a lack of standardized survey instruments that capture the prevalence.Purpose of the studyOur goal was to construct and validate a structured headache questionnaire for Arabic-speaking headache patients to be used as an epidemiological survey instrument.MethodsWe developed a culturally adapted interviewer-administered questionnaire in Arabic language comprising two sets of questions. The first set included personal and sociodemographic data together with a screening question regarding the presence of headaches over the last year. The second set was designed to define the type and pattern of headaches according to the International Classification of Headache Disorders criteria (for subjects with “yes” answers on the screening question). Validation process took place in two phases through probability random sampling selected from 1,221 headache subjects collected in an epidemiological survey 3 (n=70) and 6 months (n=232) later. A detailed assessment of patients’ headaches was performed by neurologists (blinded from the questionnaire diagnosis) who clinically assessed the patients’ headache.ResultsThe validity of the questionnaire was tested in 232 subjects with a mean age of 41.2±10.9 years, 72.8% of whom were females. The mean time to complete the questionnaire was 8.4±1.7 minutes. The intraclass correlation coefficient was 0.903 (95% confidence interval: 0.875–0.925), the Cronbach κ coefficient was 0.775 (95% confidence interval: 0.682–0.837), and the percentage of agreement was 84.5%.ConclusionOur results support the use of this comprehensive questionnaire as a valid tool for headache assessment among Arabic-speaking patients.

The diagnostic accuracy of headache measurement instruments: A systematic review and meta-analysis focusing on headaches associated with musculoskeletal symptoms

“…For migraine, chronic migraine, and probable migraine (13,14,52,54,56) five studies had a sensitivity above 0.70, which was also found for TTH, chronic TTH, and probable TTH in five studies (see Table 1) (13,14,52–54). All six studies that reported specificity, had a specificity of 0.70 or higher for migraine, chronic migraine, and probable migraine and for TTH chronic TTH, and probable TTH (13,14,52,53,55,56).…”

“…The aim of the index tests differed between the included seven articles, where four were ‘replacement’ tests (13,54–56), one a ‘triage’ test (14) and two aims were unclear (52,53). Three articles established the diagnostic accuracy for several migraine and TTH ICHD diagnoses aside from the “standard” diagnoses, including chronic migraine, chronic TTH, probable migraine, and probable TTH (14,52,53). For migraine, the sensitivity ranged from 0.49 (53) to 1.00 (54) and the specificity ranged from 0.85 (56) to 0.96 (13).…”

“…For migraine, the sensitivity ranged from 0.49 (53) to 1.00 (54) and the specificity ranged from 0.85 (56) to 0.96 (13). For chronic migraine, the sensitivity and specificity were 0.71 and 0.98 respectively (52). Probable migraine had a sensitivity of 0.89 and a specificity of 0.54 (14).…”

“…One study did not establish the specificity results from their test (54). Chronic TTH was tested in two studies, for which the sensitivity was 0.64 (53) to 0.70 (52) and the specificity 0.96 (52) to 1.00 (53). The test for probable TTH had a sensitivity of 0.92 and a specificity of 0.48 (14).…”

<p>Interferon-Beta-Induced Headache in Patients with Multiple Sclerosis: Frequency and Characterization</p>

“…Patients with reported headaches were asked to recall their headache characteristics and patterns using an intervieweradministered Arabic-language-structured validated questionnaire with an excellent intraclass correlation coefficient (ICC) of 0.903 (95% CI: 0.875-0.925) and overall Cronbach's coefficient of 0.775 (95% CI: 0.682-0.837). 19 An addendum was added to this validated questionnaire to determine the temporal relationship between commencement of interferon treatment and headache onset and characteristics. Patients were asked whether their headaches were pre-existing or appeared de novo, and had worsened or improved (in terms of frequency and intensity).…”