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Development and Validation of a Japanese-Language Questionnaire to Screen for Tension-Type Headaches and Migraines

Introduction Migraine and tension-type headache (TTH) are chronic diseases associated with significant socioeconomic losses and social and psychological impact (current global prevalence: 10% and 38%, respectively). Thus, they require accurate identification and classification. In clinical practice,...

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Autores principales: Tanobe, Kaho, Machida, Minori, Motoya, Ryo, Takeoka, Atsushi, Danno, Daisuke, Miyahara, Junichi, Takeshima, Takao, Kumano, Hiroaki, Tayama, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10548312/
https://www.ncbi.nlm.nih.gov/pubmed/37799235
http://dx.doi.org/10.7759/cureus.44633
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author Tanobe, Kaho
Machida, Minori
Motoya, Ryo
Takeoka, Atsushi
Danno, Daisuke
Miyahara, Junichi
Takeshima, Takao
Kumano, Hiroaki
Tayama, Jun
author_facet Tanobe, Kaho
Machida, Minori
Motoya, Ryo
Takeoka, Atsushi
Danno, Daisuke
Miyahara, Junichi
Takeshima, Takao
Kumano, Hiroaki
Tayama, Jun
author_sort Tanobe, Kaho
collection PubMed
description Introduction Migraine and tension-type headache (TTH) are chronic diseases associated with significant socioeconomic losses and social and psychological impact (current global prevalence: 10% and 38%, respectively). Thus, they require accurate identification and classification. In clinical practice, validated screening tools able to quickly determine migraine and TTH with high sensitivity and specificity help provide an objective and multifaceted understanding of patients' headache symptoms. However, no tool has been developed or validated yet in Japan to ask multifaceted questions about headache-related symptoms in order to identify migraine and TTH and understand these symptoms. This study aimed to develop a questionnaire for screening TTH and migraine. Methods The study was conducted from March to June 2022 at a medical institution in Osaka, Japan. The questionnaire - comprising 24 questions that were generated based on the 3rd edition of the International Classification of Headache Disorders - was used to screen for migraine and TTH, aiming for a deeper understanding of related symptoms. The participants were patients aged ≥18 years with at least one of the following diagnoses: migraine, TTH. The participants were asked to respond in writing or online. The inclusion criteria were age ≥18 years; headache patients attending a hospital; and diagnoses of at least one of the following: migraine, TTH. The informativeness and discriminating ability of the screening items were evaluated using the item response theory. Items with a calculated discrimination ≥1.35 (high or very high) were retained for screening purposes. Basic questions required to screen for primary headaches were retained, despite their limited computational discrimination power. Ultimately, nine and eight screening items were finalized for migraine and TTH, respectively. The previous neurologists' clinical diagnosis of each patient was used as the gold standard reference for calculating sensitivity, specificity, and positive and negative predictive values regarding the screening items. Cohen's kappa coefficients with 95% CIs were also calculated to determine the agreement between the neurologists' clinical diagnosis and the questionnaire results. Results The study population comprised 69 patients aged 19-89 years who were assisted at a hospital division specializing in headache medicine and diagnosed by neurologists. Of these, 22 patients had migraine, 30 had TTH, and 17 had migraine/TTH. Comparing the neurologists’ clinical diagnosis with our screening questionnaire results, the sensitivity and specificity were 72.7% and 86.7% for migraine and 50.0% and 86.4% for TTH, respectively. Conclusions Our brief screening tool was highly specific for diagnosing migraine and TTH in individuals with headache symptoms but lacked sufficient sensitivity, especially for TTH. The high specificity for migraine and TTH suggests that the screening tool we developed in this study can correctly identify those who do not have migraine and TTH. The sensitivity was also relatively high for migraine, suggesting that the tool can correctly identify migraine-positive individuals. However, the sensitivity for TTH was low. This tool could help clinicians in providing detailed course assessment of migraine symptoms and TTH symptoms; however, the issue of low sensitivity for TTH needs to be addressed.
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spelling pubmed-105483122023-10-05 Development and Validation of a Japanese-Language Questionnaire to Screen for Tension-Type Headaches and Migraines Tanobe, Kaho Machida, Minori Motoya, Ryo Takeoka, Atsushi Danno, Daisuke Miyahara, Junichi Takeshima, Takao Kumano, Hiroaki Tayama, Jun Cureus Neurology Introduction Migraine and tension-type headache (TTH) are chronic diseases associated with significant socioeconomic losses and social and psychological impact (current global prevalence: 10% and 38%, respectively). Thus, they require accurate identification and classification. In clinical practice, validated screening tools able to quickly determine migraine and TTH with high sensitivity and specificity help provide an objective and multifaceted understanding of patients' headache symptoms. However, no tool has been developed or validated yet in Japan to ask multifaceted questions about headache-related symptoms in order to identify migraine and TTH and understand these symptoms. This study aimed to develop a questionnaire for screening TTH and migraine. Methods The study was conducted from March to June 2022 at a medical institution in Osaka, Japan. The questionnaire - comprising 24 questions that were generated based on the 3rd edition of the International Classification of Headache Disorders - was used to screen for migraine and TTH, aiming for a deeper understanding of related symptoms. The participants were patients aged ≥18 years with at least one of the following diagnoses: migraine, TTH. The participants were asked to respond in writing or online. The inclusion criteria were age ≥18 years; headache patients attending a hospital; and diagnoses of at least one of the following: migraine, TTH. The informativeness and discriminating ability of the screening items were evaluated using the item response theory. Items with a calculated discrimination ≥1.35 (high or very high) were retained for screening purposes. Basic questions required to screen for primary headaches were retained, despite their limited computational discrimination power. Ultimately, nine and eight screening items were finalized for migraine and TTH, respectively. The previous neurologists' clinical diagnosis of each patient was used as the gold standard reference for calculating sensitivity, specificity, and positive and negative predictive values regarding the screening items. Cohen's kappa coefficients with 95% CIs were also calculated to determine the agreement between the neurologists' clinical diagnosis and the questionnaire results. Results The study population comprised 69 patients aged 19-89 years who were assisted at a hospital division specializing in headache medicine and diagnosed by neurologists. Of these, 22 patients had migraine, 30 had TTH, and 17 had migraine/TTH. Comparing the neurologists’ clinical diagnosis with our screening questionnaire results, the sensitivity and specificity were 72.7% and 86.7% for migraine and 50.0% and 86.4% for TTH, respectively. Conclusions Our brief screening tool was highly specific for diagnosing migraine and TTH in individuals with headache symptoms but lacked sufficient sensitivity, especially for TTH. The high specificity for migraine and TTH suggests that the screening tool we developed in this study can correctly identify those who do not have migraine and TTH. The sensitivity was also relatively high for migraine, suggesting that the tool can correctly identify migraine-positive individuals. However, the sensitivity for TTH was low. This tool could help clinicians in providing detailed course assessment of migraine symptoms and TTH symptoms; however, the issue of low sensitivity for TTH needs to be addressed. Cureus 2023-09-04 /pmc/articles/PMC10548312/ /pubmed/37799235 http://dx.doi.org/10.7759/cureus.44633 Text en Copyright © 2023, Tanobe et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Tanobe, Kaho
Machida, Minori
Motoya, Ryo
Takeoka, Atsushi
Danno, Daisuke
Miyahara, Junichi
Takeshima, Takao
Kumano, Hiroaki
Tayama, Jun
Development and Validation of a Japanese-Language Questionnaire to Screen for Tension-Type Headaches and Migraines
title Development and Validation of a Japanese-Language Questionnaire to Screen for Tension-Type Headaches and Migraines
title_full Development and Validation of a Japanese-Language Questionnaire to Screen for Tension-Type Headaches and Migraines
title_fullStr Development and Validation of a Japanese-Language Questionnaire to Screen for Tension-Type Headaches and Migraines
title_full_unstemmed Development and Validation of a Japanese-Language Questionnaire to Screen for Tension-Type Headaches and Migraines
title_short Development and Validation of a Japanese-Language Questionnaire to Screen for Tension-Type Headaches and Migraines
title_sort development and validation of a japanese-language questionnaire to screen for tension-type headaches and migraines
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10548312/
https://www.ncbi.nlm.nih.gov/pubmed/37799235
http://dx.doi.org/10.7759/cureus.44633
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