Validation of The 3-Question Headache Screen in The Diagnosis of Migraine in Nigeria

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KolawoleWahab
AsuwemheUgheoke
Peter Okokhere
Titus Ibekwe

Abstract

BACKGROUND: Migraine is a chronic episodic disorder that is still under-diagnosed and undertreated.A rapid diagnostic method is desirable so that treatment can be initiated early. We compared the 3-question headache screen with the International Headache Society (IHS) criteria in the diagnosis ofmigraine among Nigerians.METHODS: Using a multi-stage sampling technique, 1513 respondents were screened for migraineusing both the IHS criteria and the 3-question headache screen. A statistical comparison of the twodiagnostic methods was then done by determination of kappa coefficient, sensitivity and specificity.RESULTS: The prevalence of migraine obtained using the IHS criteria was 9.6% (95% CI, 8.1%-11.1%)while it was 8.3% (95% CI, 8.1%-8.5%)with the use of the 3-question headache screen. There was a goodagreement between the IHS criteria and the 3-question headache screen (k=0.68, p<0.001). The 3-question headache screen had a sensitivity of 66.2% (95% CI, 58.5%-73.9%), specificity of 97.8% (95%CI, 97.0%-98.6%), positive predictive value of 76.2% (95% CI, 68.8%-83.6%) and a negative predictivevalue of 96.5% (95% CI, 95.5%-97.5%).CONCLUSION: The 3-question headache screen is sensitive and specific in making a rapid diagnosis ofmigraine among Nigerians. Its use is thus encouraged so that appropriate management of the conditioncan be initiated early in order to reduce associated disability.

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Author Biographies

KolawoleWahab

Division of Neurology,

Department of Medicine

AsuwemheUgheoke, Irrua, Nigeria

Department of Medicine,

Irrua Specialist Teaching Hospital

Peter Okokhere, Irrua, Nigeria

Department of Medicine,

Irrua Specialist Teaching Hospital

Titus Ibekwe, University of Abuja, Abuja, Nigeria

Department of Otorhinolaryngology