A Possible Role of ID-Migraine™ in the Emergency Department: Study of an Emergency Department Out-Patient Population

• Published in: Cephalalgia 2009-12, Vol.29 (12), p.1326-1330
• Main Authors: Mostardini, C, d'Agostino, VC, Dugoni, DE, Cerbo, R
• Format: Article
• Language: English
• Subjects: Adult; Diagnosis, Differential; emergency department; Emergency Medical Services - methods; Emergency Medical Services - standards; Female; headache diagnostic accuracy; Humans; ID‐Migraine screener; Male; Mass Screening - methods; Mass Screening - standards; Middle Aged; migraine; migraine diagnosis; Migraine Disorders - diagnosis; Outpatients; Pilot Projects; Predictive Value of Tests; Reproducibility of Results; Sensitivity and Specificity; Surveys and Questionnaires - standards; Young Adult
• ISSN: 0333-1024; 1468-2982
• DOI: 10.1111/j.1468-2982.2009.01889.x

Headache symptoms account for 1-3% of admissions to an emergency department (ED). Most patients affected by a primary headache (PH) have migraine, although they are often misdiagnosed as ‘headache not otherwise specified’. We investigated the possibility of using ID-Migraine (ID-M) to improve migraine recognition in the ED setting. We planned a pilot study involving ED out-patients with a diagnosis of PH. Diagnoses of a blinded headache expert were subsequently matched with the ID-M results. We tested ID-M on 230 patients (199 PH, 31 secondary headaches). Considering only PH, ID-M exhibited a sensitivity of 0.94 and specificity of 0.83 with a positive predictive value (PPV) of 0.99. The ID-M is a simple migraine screener with high sensitivity, high specificity and high PPV, even in an ED-derived population. Methodical use of this tool in an ED setting may, once a secondary headache has been excluded, lead to rapid diagnosis of migraine.