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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Three-question screening tool identifies
patients with Migraine |
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BY DON SCHRADER
Contributing Writer |
CHICAGO
(ECCC)— Undiagnosed migraine can be identified with
a high level of accuracy by use of a three-question screening
tool, according to results of a study reported April 16 during
the annual meeting of the American Academy of Neurology.
Use of the screening test, called ID Migraine, led to a 16-fold
increase in the number of patients with migraine identified in
an ophthalmology clinic and tripled the number of migraine
diagnoses in an ear, nose, and throat clinic, reported Dr.
Mustafa Ertas, a neurologist at Anadolu Medical Center in
Istanbul, Turkey. The brief screening test led to a diagnostic
rate comparable to that of clinical diagnosis in a neurology
clinic.
“The sensitivity and specificity and the positive and negative
predictive values are comparable in different clinics,” Dr.
Ertas concluded. “The possibility of migraine should be
considered in all patients who are admitted to an ophthalmology
clinic and an ENT clinic.”
The screening tool evolved from the recognition that migraine is
more likely to be misdiagnosed in patients who have comorbid
conditions. Both primary care and specialist physicians may
overlook migraine in patients whose primary complaints involve
other conditions, said Dr. Ertas. The ID Migraine previously was
validated in primary care and headache specialty clinics
(Neurology. 2003;61:375-382).
Clinicians in 11 cities administered the ID Migraine screening
test to 2,625 patients: 1,021 patients in neurologic clinics,
889 in ENT clinics, and 715 in ophthalmology clinics. The test
consists of three questions: 1) Has a headache limited your
activities for a day or more in the last three months? 2) Are
you nauseated or sick to your stomach when you have a headache?
3) Does light bother you when you have a headache more so than
when you do not have a headache?
Patients who answer “yes” to at least two of the three questions
are considered as a positive test.
Dr. Ertas reported that 1.3% of the patients at ophthalmologic
clinics had been evaluated for a primary complaint of headache,
as had 5.4% of patients at ENT clinics and 37.6% of patients at
neurology clinics. At the end of the study, 20.8% of
ophthalmology patients tested positive for headache by means of
the ID Migraine screening tool, as did 16% of the ENT patients,
and 33.1% of the neurology clinic patients.
Dr. Ertas said the screening test demonstrated similar accuracy
in all three clinic settings. |
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