Single-item migraine screening tests, self-reported bothersome headache or stripe pattern hypersensitivity?

Acta Neurol Scand. 2016 Oct;134(4):277-83. doi: 10.1111/ane.12539. Epub 2015 Dec 1.

Abstract

Background: A simple screening tool may potentially help the migraine diagnosis in a primary care setting. The use of single-item tests, such as stripe pattern hypersensitivity test and self-reported bothersome headache (HA) question, as migraine screening tools have not been fully explored.

Methods: Two hundred and fifty-four subjects (patients and companions) were randomly enrolled from an OB/GYN clinic (men 82, women 172; age 38 ± 14). They were instructed to rate the stripe sensitivity level (0-4) and to report any bothersome HA (yes/no). A brief structured HA interview was conducted to describe the HA characteristics and for migraine diagnosis based on the ICHD-IIIβ criteria.

Results: In a multivariate model, bothersome HA question and stripe pattern hypersensitivity test were both significantly associated with EM+PM+CM (odds ratio: 24.0, P < 0.01 vs 2.6, P = 0.01) or EM (odds ratio: 16.2, P < 0.01 vs 3.0, P < 0.01). Bothersome HA question had a greater screening power than stripe pattern hypersensitivity for screening EM+PM+CM (area under the ROC curve: 0.84 [95% CI 0.78-0.89] vs 0.62 [95% CI 0.55-0.69]) or EM (area under the ROC curve: 0.80 [95% CI 0.73-0.86] vs 0.64 [95% CI 0.56-0.72]).

Conclusion: When performed in an OB/GYN clinic, self-reported bothersome HA question seemed more powerful than visual stripe pattern test in screening migraine thus could potentially be used as a single-item screening test.

Keywords: migraine; screening; stripe sensitivity.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Female
  • Headache / diagnosis*
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Migraine Disorders / diagnosis*
  • Photic Stimulation / adverse effects*
  • Photosensitivity Disorders / diagnosis*
  • Pregnancy
  • ROC Curve
  • Young Adult