Diagnosis and development of screening items for migraine in neurological practice in Taiwan. Export

@article{citeulike:4302314, abstract = {BACKGROUND/PURPOSE: The objectives of this study were to: (1) survey migraine diagnoses among neurological outpatients in Taiwan; (2) compare neurologists' migraine diagnoses with the International Classification of Headache Disorders 2nd Edition (ICHD-2) criteria; and (3) evaluate the diagnostic ability of screening items on a patient migraine questionnaire. METHODS: This prospective study surveyed patients who consulted neurologists for the first time with a chief complaint of headache, excluding those experiencing headaches for > or = 15 days/month. Each neurologist interviewed a maximum of 10 patients. Patients were asked to complete a self-administered questionnaire and their physicians completed another questionnaire. The physicians were asked if patients could be diagnosed with migraine. In addition, a diagnosis of ICHD-2 migraine was made by the physician's questionnaire through a computer-generated algorithm. In this study, migraine without aura (code 1.1) or migraine with aura (code 1.2) were designated as "strict migraine", and the combination of strict migraine and ICHD-2 probable migraine (code 1.6) as "any migraine". RESULTS: Among 755 patients who were eligible for analysis, 537 (71\%) were diagnosed as having "any migraine", 363 (48\%) with "strict migraine", and 451 (60\%) with physician-diagnosed migraine. Among the 537 patients diagnosed as having "any migraine", 308 patients (57\%) had not been diagnosed by any physician before. A moderate agreement (kappa statistic around 0.5) was found between the physicians' diagnoses and ICHD-2 "strict migraine" or "any migraine". In patients with ICHD-2 probable migraine (n = 174), only 52\% were diagnosed with migraine by our physicians. Nausea was the best single item for predicting migraine diagnosis, while any combination of two items among nausea/vomiting, moderate or severe pain and photophobia, provided the optimum screening tool. CONCLUSION: Migraine was the most common headache diagnosis in the neurologists' clinics. Probable migraine was not completely adopted as a migraine spectrum among neurologists. In contrast to ID Migraine(TM), moderate or severe headache intensity replaced headache-related disability as one screening item for migraine in Taiwan.}, author = {Wang, S. J. and Fuh, J. L. and Huang, S. Y. and Yang, S. S. and Wu, Z. A. and Hsu, C. H. and Wang, C. H. and Yu, H. Y. and Wang, P. J. and {}}, citeulike-article-id = {4302314}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/18583220}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=18583220}, issn = {0929-6646}, journal = {Journal of the Formosan Medical Association = Taiwan yi zhi}, keywords = {headache}, month = {June}, number = {6}, pages = {485--494}, posted-at = {2009-04-12 02:17:26}, priority = {2}, title = {Diagnosis and development of screening items for migraine in neurological practice in Taiwan.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/18583220}, volume = {107}, year = {2008} }

TY - JOUR ID - citeulike:4302314 L3 - citeulike-article-id:4302314 N2 - BACKGROUND/PURPOSE: The objectives of this study were to: (1) survey migraine diagnoses among neurological outpatients in Taiwan; (2) compare neurologists' migraine diagnoses with the International Classification of Headache Disorders 2nd Edition (ICHD-2) criteria; and (3) evaluate the diagnostic ability of screening items on a patient migraine questionnaire. METHODS: This prospective study surveyed patients who consulted neurologists for the first time with a chief complaint of headache, excluding those experiencing headaches for > or = 15 days/month. Each neurologist interviewed a maximum of 10 patients. Patients were asked to complete a self-administered questionnaire and their physicians completed another questionnaire. The physicians were asked if patients could be diagnosed with migraine. In addition, a diagnosis of ICHD-2 migraine was made by the physician's questionnaire through a computer-generated algorithm. In this study, migraine without aura (code 1.1) or migraine with aura (code 1.2) were designated as "strict migraine", and the combination of strict migraine and ICHD-2 probable migraine (code 1.6) as "any migraine". RESULTS: Among 755 patients who were eligible for analysis, 537 (71%) were diagnosed as having "any migraine", 363 (48%) with "strict migraine", and 451 (60%) with physician-diagnosed migraine. Among the 537 patients diagnosed as having "any migraine", 308 patients (57%) had not been diagnosed by any physician before. A moderate agreement (kappa statistic around 0.5) was found between the physicians' diagnoses and ICHD-2 "strict migraine" or "any migraine". In patients with ICHD-2 probable migraine (n = 174), only 52% were diagnosed with migraine by our physicians. Nausea was the best single item for predicting migraine diagnosis, while any combination of two items among nausea/vomiting, moderate or severe pain and photophobia, provided the optimum screening tool. CONCLUSION: Migraine was the most common headache diagnosis in the neurologists' clinics. Probable migraine was not completely adopted as a migraine spectrum among neurologists. In contrast to ID Migraine(TM), moderate or severe headache intensity replaced headache-related disability as one screening item for migraine in Taiwan. IS - 6 JF - Journal of the Formosan Medical Association = Taiwan yi zhi SN - 0929-6646 EP - 494 TI - Diagnosis and development of screening items for migraine in neurological practice in Taiwan. VL - 107 SP - 485 KW - headache AU - Wang, SJ AU - Fuh, JL AU - Huang, SY AU - Yang, SS AU - Wu, ZA AU - Hsu, CH AU - Wang, CH AU - Yu, HY AU - Wang, PJ PY - 2008/06// UR - http://view.ncbi.nlm.nih.gov/pubmed/18583220 ER -