The Sensitivity and Specificity of the Case Definition Criteria in Diagnosis of Headache: A School-Based Epidemiological Study of 5562 Children in Mersin

Abstract

The objectives of the present study were to estimate the prevalence of recurrent headaches in schoolchildren (ranging from 2nd to 5th degrees) in Mersin city of Turkey and to determine the sensitivity, specificity, positive predictive value and positive likelihood ratio of the diagnostic headache characteristics in children with migraine and Tension Type Headache (TTH) using neurologist's diagnosis as the gold standard. The stratified sample of study was composed of 5562 children. The prevalence of recurrent headache was 49.2% (2739 of 5562) and the prevalence of current headache was 31.3% (859 of 2739). TTH was more common than migraine (24.7% vs. 10.4%). The most sensitive headache characteristic for migraine was 'severity of pain' and the most sensitive definitive symptom is 'duration of headache' in children with TTH. IHS-based symptom definition criteria are highly beneficial in diagnosis of childhood headache, if used together with detailed clinical assessment.

Prevalences of primary headache symptoms at school-entry: a population-based epidemiological survey of preschool children in Germany

“…Surprisingly preschool boys experience highly frequent recurrent headaches more often than girls of this age (boy/girl ratio 10:1). As internationally reported (e.g., Özge et al [8]), further specific influences on pain characteristics by gender or social class have not been detected for our examined sample, being 5-6 years of age.…”

“…However, recurrent headache and abdominal pain without organic reasons are the most common pain symptoms in children [2][3][4][5][6][7][8][9][10][11][12]. A high comorbidity between these two aversive syndromes is reported [6,13], which seems to continuously increase over time [2,6,7,14].…”

“…The 2004 IHS classification for headaches [25] and the ROME-II criteria for abdominal pain [26], to be revised as Rome-III in 2006, are widely accepted but also criticised examples [27][28][29][30]. When reimplementing resulting descriptive classification rules to clinical practice, the paediatrist, for example, in his attempt to diagnose the observed pain symptoms of a certain child at a given time, meets problems, which have been described earlier [8,11,28,[30][31][32]. Additionally, results from epidemiological studies of headache and abdominal pain vary not only due to differences between study populations, methods, diagnostic criteria and their interpretations, but also because pain symptoms show extremely diverse interindividual variations over time [27][28][29][30][31][32][33][34].…”

“…This statement is also true for functional abdominal pain in children. When revising the literature, Özge [8] reported published prevalences for headaches among schoolchildren from 5.9% to 82%. Further, different authors only found e.g., a poor agreement between headache frequency and intensity reported retrospectively in questionnaires and interviews compared with continuously registered data from diaries [27,35,36].…”

Present and previous psychopathology of juvenile onset migraine: a pilot investigation by Child Behavior Checklist

“…Population-based studies reported that the prevalence of migraine in childhood and adolescence ranges from 3% to 14% [1][2][3][4][5][6]. From the time of Wolff's early portrait of the childhood personality characteristics of migraine patients, the research began to explore the association of headache first with broad personality traits and then with distinct psychiatric symptoms [7,8].…”