Improving the detection of chronic migraine: Development and validation of Identify Chronic Migraine (ID-CM)

Abstract

BackgroundMigraine, particularly chronic migraine (CM), is underdiagnosed and undertreated worldwide. Our objective was to develop and validate a self-administered tool (ID-CM) to identify migraine and CM.MethodsID-CM was developed in four stages. (1) Expert clinicians suggested candidate items from existing instruments and experience (Delphi Panel method). (2) Candidate items were reviewed by people with CM during cognitive debriefing interviews. (3) Items were administered to a Web panel of people with severe headache to assess psychometric properties and refine ID-CM. (4) Classification accuracy was assessed using an ICHD-3β gold-standard clinician diagnosis.ResultsStages 1 and 2 identified 20 items selected for psychometric validation in stage 3 (n = 1562). The 12 psychometrically robust items from stage 3 underwent validity testing in stage 4. A scoring algorithm applied to four symptom items (moderate/severe pain intensity, photophobia, phonophobia, nausea) accurately classified most migraine cases among 111 people (sensitivity = 83.5%, specificity = 88.5%). Augmenting this algorithm with eight items assessing headache frequency, disability, medication use, and planning disruption correctly classified most CM cases (sensitivity = 80.6%, specificity = 88.6%).DiscussionID-CM is a simple yet accurate tool that correctly classifies most individuals with migraine and CM. Further testing in other settings will also be valuable.

The Diagnosis and Management of Chronic Migraine in Primary Care

“…2 A questionnaire which considers a number of the clinical features of chronic migraine and which can be completed by the patient prior to the physician visit has also been developed. 5 Patients may access, complete and print this chronic migraine screening tool at the Allergan-sponsored website. 6 It is not a diagnostic tool, but is meant to alert the patient and the physician that the patient may have chronic migraine.…”

Assessing Physician‐Patient Dialogues About Chronic Migraine During Routine Office Visits

“…[39][40][41][42] These instruments can assist in making diagnoses, track levels of treatment optimization, and aid clinicians in improving treatment by pinpointing specific areas of need. [39][40][41][42] These instruments can assist in making diagnoses, track levels of treatment optimization, and aid clinicians in improving treatment by pinpointing specific areas of need.…”

“…Further, making use of validated clinical tools developed to aid in the assessment, diagnosis, and effective treatment of migraine and CM, including ID Migraine TM , ID Chronic Migraine (ID-CM), the Migraine Treatment Optimization Questionnaire (mTOQ-6), the Headache Under-Response to Treatment (HURT) Index, and the Migraine Assessment of Current Therapy (Migraine ACT), to monitor treatment optimization among patients can help bridge the gaps identified in the dialogues. [39][40][41][42] These instruments can assist in making diagnoses, track levels of treatment optimization, and aid clinicians in improving treatment by pinpointing specific areas of need. In the case of the mTOQ-6, deficits in the various domains may suggest specific actions including using CM-specific therapies, adding preventive pharmacologic interventions, and adding empirically supported behavioral interventions.…”

Fibromyalgia Among Patients With Chronic Migraine and Chronic Tension‐Type Headache: A Multicenter Prospective Cross‐Sectional Study – A Response

“…For the diagnosis of CM and CTTH, we diagnosed CM and CTTH based on the headache history during the previous year according to ICHD‐III beta . CM is a disease that is often delayed in diagnosis or treatment, so it is very common to see a history of headache for more than 1 year in first‐visit patients with headache . We tried to recruit all eligible CM or CTTH patients who firstly visited our clinics.…”

“…2 CM is a disease that is often delayed in diagnosis or treatment, so it is very common to see a history of headache for more than 1 year in firstvisit patients with headache. 3 We tried to recruit all eligible CM or CTTH patients who firstly visited our clinics. Nevertheless, we did not collect data for total potential eligible patients and those who declined to participate in our study.…”