A self-administered screener for migraine in primary care

Migraine is a common and disabling condition often undiagnosed in primary care. This study developed a self-administered migraine screener for patients with headache complaints. A total of 563 patients completed this screener during routine primary care visits. Of these patients, 451 (80%) underwent a thorough evaluation by a headache expert. Diagnosis was based on International Headache Society criteria using a semi-structured interview. Among nine diagnostic questions, a three-item subset showed the best performance. This subset included disability, nausea, and sensitivity to light. The screener had a sensitivity of 81%, specificity of 75%, and a positive predictive value of 93%. Test-retest reliability was also strong, with a kappa value of 0.68. The performance of the three-item screener was consistent across different sexes and ages. This tool could greatly enhance migraine recognition in primary care settings due to its simplicity. Clinical relevance: This study shows that a brief migraine screener can improve diagnosis in primary care.