Validation of diagnostic criteria for migraine in the Zürich longitudinal cohort study

Abstract

This paper reports the results of a systematic assessment of the validity of the specific diagnostic criteria for migraine without aura, as defined by the International Headache Society (IHS), in a longitudinal epidemiologic sample of young adults who were selected from the general population of Zürich, Switzerland. Systematic modification of each of the IHS criteria for migraine without aura yielded one-year weighted prevalence rates ranging from 24% for the unmodified IHS criteria to 9% for the most restrictive definition of migraine. The major implications of the findings for the IHS criteria are: (a) they provide adequate coverage to classify the majority of subjects with headache in the general population; (b) there is little overlap between migraine and tension-type headache, suggesting that the criteria define moderately independent subgroups; (c) the criteria for migraine without aura appear to be too unrestrictive for application in the community, particularly among young adults at the peak period of incidence of migraine; (d) the criteria for "aura" need more precise operationalization; and (e) models of validation of the diagnostic criteria suggest that Criterion D of the IHS criteria for migraine without aura should be modified to require both gastrointestinal symptoms and photophobia and phonophobia.

Latent class and genetic analysis does not support migraine with aura and migraine without aura as separate entities

“…The classification of migraine has been impeded by the lack of pathognomonic markers for migraine, co-occurrence of migraine subtypes as well as migraine and tension-type headache within the same individual, and the lack of validity of inclusion criteria and thresholds for distinguishing disorder from nondisorder and the boundaries between migraine and other headache subtypes [Merikangas et al, 1993[Merikangas et al, , 1994. The nature of the association between two major subtypes of migraine defined by the International Headache Society (IHS) criteria [Headache Classification Committee of the International Headache Society, 1988], i.e., migraine without aura (MO) and migraine with aura (MA), was examined in several community, family, and twin studies.…”

Sensitivity and specificity of the new international diagnostic criteria for migraine with aura

“…Previous validation studies of the ICHD-1 encountered similar methodological problems. [25][26][27][28] The validity of the ICHD-1 for migraine without aura has been evaluated using logistic regression models with subjective distress as a validation criterion. 25 26 However, this criterion is generally regarded as not suitable.…”

Pharmaceutically treated comorbidities and associated healthcare costs among triptan users in Switzerland: A pharmacoepidemiological study from a nationwide health insurance database

“…But, prior epidemiologic studies have primarily focused on one single condition, mostly psychiatric disorders including anxiety and depression, and thus only few recent work investigated a variety of comorbidities . Furthermore, previous research was based on carefully selected patient populations and there is only a small number of (inter‐)national studies providing a current and comprehensive overview of comorbidities and treatment patterns in real‐life patients and the associated healthcare costs of migraine …”