The Telegraph
Since 1st March, 1999
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Three-step test for migraine

Houston, Aug. 19 (PTI): Got a severe headache and want to confirm whether it is migraine or not' Well, just answer three simple questions, which are accurate enough to detect the cause of this shooting pain in your head.

Over 28 million Americans and billions of people worldwide suffering from migraine, a complex biological disease, can now heave a sigh of relief thanks to a new test that can detect the disease in no time.

The ID Migraine, a simple three-question test, can identify patients with migraine with complete accuracy.

Developed by a team of researchers and validated in a national study that appeared in the current issue of the journal of the American Academy of Neurology, the authors report that answering “yes” to two out of three simple questions identifies migraine sufferers.

The questions are: has a headache limited your activities for a day or more in the last three months' Are you nauseated or sick to your stomach when you have a headache' Does light bother you when you have a headache'

“ID Migraine should be used in a primary care setting, where many patients with migraine may go undiagnosed,” says lead author Richard B. Lipton, MD Professor and vice-chair of neurology at the Albert Einstein College of Medicine.

“Despite the high prevalence of migraine and its associated pain and disability, diagnostic rates for migraine remain low,” Lipton says.

“ID Migraine is very easy to use for both patients and doctors and we hope it will prompt patients to talk to their primary-care doctor to get diagnosed and to receive treatments that will relieve their pain and improve their ability to function.”

The authors tested the validity and reliability of the test at 27 primary care sites and 12 headache speciality practice sites in the US. As many as 443 patients making routine primary-care physician visits for any reason completed a nine-question survey.

Patients in the study either had headaches that interfered with their ability to work, study or their regular activities; or said they wanted to talk to their physicians about their headaches.

All the patients were then referred to one of the 12 headache speciality centres, where specialists diagnosed them without knowing how they had answered the questionnaire.

The patient’s diagnosis was compared to the answers given. An analysis identified the three questions that at best predicted a migraine diagnosis. Of the patients who answered “yes” to two of the three questions, 93 per cent were diagnosed by the headache experts as suffering from migraine.

“Because patients with migraine are often present in the primary-care setting, the hope is that ID Migraine will help primary care doctors identify migraine quickly and easily,” Lipton says.

“Given the availability of effective treatment, use of the screening tool might represent an important step toward reducing the burden of this illness.

“Headaches sometime have serious causes not identified by the screener. Whether a patient has migraine or headaches due to other conditions, the ID Migraine screener can help facilitate patient physician communication and the exchange of important information.”

Migraine is reportedly more common than diabetes (16 million cases) and asthma (10.6 million) and is more prevalent in women. Almost one in five women and one in 15 men suffer from migraine.

Fifty per cent of individuals reported in one study that during their migraine attacks, they experience severe functional impairment and may require complete bed rest.

The impairment and impact on health-related quality of life of migraine is substantial, equivalent to or greater than other chronic medical illnesses such as angina, diabetes and hypertension.

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