Introduction
Materials and methods
The fourth Nord-Trøndelag health survey (HUNT4)
Study population of the validation study
Sample size calculation
Headache questionnaire in HUNT4
Questions | Answer options |
---|---|
First questionnaire (Q1) | |
Have you ever had migraine? | Yes or no |
If yes; Age of onset | Years of age |
Second questionnaire (Q2) | |
Have you suffered from headache during the last year? If yes; what type of headache? | a) Yes or no Migraine or other headache |
State the average number of headache days per month | Less than 1 day, 1–6 days, 7–14 days, or more than 14 days |
Usually, what is the pain intensity? | Mild (does not inhibit daily activities), moderate (inhibiting, but not preventing daily activities), or severe (daily activities suspended) |
For how long does the headache attack usually last? | Less than 4 h, 4 h-1 day, 1–3 days, or more than 3 days |
Is the headache usually accompanied or dominated by: a) Pulsating pain? b) Pressing pain? c) One-sided pain (right or left)? d) Getting worse by physical activity? e) Nausea and/or vomiting? f) Increased sensitivity to light and sound? | a-f) Yes or no |
Prior to or during headache; could you temporary have visual disturbance? (flickering lights, spots or lines, loss of vision) | Yes or no |
I. ICHD-3 modified migraine criteria (restrictive migraine criteria)
| |
B. Headache attacks lasting < 72 ha | |
C. Headache had usually at least two of the following four characteristics: | |
1. Pulsating quality | |
2. Unilateral location | |
3. Moderate or severe pain intensity | |
4. Aggravation by physical activity | |
D. During headache, at least one of the following: | |
1. Nausea and/or vomiting | |
2. Increased sensitivity to light and sound B, C and D had to be fulfilled for the diagnosis of restrictive migraine | |
II. Migraine with aura (restrictive MA)
| |
Fulfilled the restrictive migraine criteria, and reported visual disturbance prior to or during headache | |
III. Liberal migraine criteria (definite and probable migraine)
| |
Self-reported migraine, or fulfilled the restrictive migraine criteria
IV. Lifetime migraine
Answered “yes” to the question “Have you ever had migraine?” |
Validation interview
Ethics
Statistics
Results
Participation rate in the validation interview
Response rate to the headache questionnaire
Time interval between response on questionnaire and interview
Validity of headache diagnoses
Category | Sensitivity n (%) | 95% CI | Specificity n (%) | 95% CI | Kappa value | 95% CI |
---|---|---|---|---|---|---|
Headache | ||||||
Headache sufferinga | 40/42 (95) | 89–100 | 131/182 (72) | 65–79 | 0.46 | 0.33–0.59 |
Headache sufferinga > 1 day/month | 38/42 (90) | 81–99 | 146/182 (80) | 74–86 | 0.55 | 0.41–0.69 |
Headachea > 15 days/month | 3/8 (38) | 0–81 | 212/216 (98) | 92–100 | 0.38 | 0.15–0.61 |
Headachea > 15 days/month with MOHb | 1/2 (50) | 0–100 | 222/222 (100) | 99–100 | 0.67 | 0.02–1.00 |
Migraine | ||||||
Self-reported lifetime migrainec | 42/71 (59) | 42–72 | 151/152 (99) | 98–100 | 0.65 | 0.55–0.75 |
Self-reported migraine during last year | 21/42 (50) | 34–66 | 177/182 (97) | 95–99 | 0.55 | 0.39–0.71 |
Restrictived migraine during last year | 20/42 (48) | 32–63 | 170/182 (93) | 90–96 | 0.45 | 0.28–0.62 |
Restrictived migraine > 1 day/month | 16/32 (50) | 32–68 | 182/192 (94) | 91–97 | 0.49 | 0.30–0.68 |
Restrictived migraine with visual aura | 7/21 (33) | 11–55 | 191/203 (94) | 91–97 | 0.29 | 0.03–0.55 |
Liberale migraine during last year | 27/42 (64) | 49–79 | 169/182 (93) | 90–96 | 0.58 | 0.43–0.73 |
Tension-type headache (TTH)f | ||||||
TTH > 1 day/month | 14/14 (100) | 95–100 | 154/210 (73) | 68–78 | 0.33 | 0.17–0.49 |
TTH > 15 days/month without MOH | 1/6 (17) | 0–60 | 218/218 (100) | 99–100 | 0.28 | 0.00–0.90 |