Screening general practice patients for migraine without aura: construction and validation of the Balkan Migraine Screening Questionnaire (BMSQ)

摘要

Aim To develop and validate a screening questionnaire for migrainewithout aura with sufficient diagnostic accuracy to be used inprimary care settings.Methods The study was designed as cross-sectional, multicentric,diagnostic accuracy trial of new questionnaire for screening patientswho visit general practitioners, with an aim to reveal migrainewithout aura. The instrument was constructed for the purpose ofthis study, and validated on the sample of 429 primary care outpatients.The gold standard of diagnosing migraine without aurawas clinical estimate by a neurologist based on the InternationalClassification of Headache Disorders 3rd edition (ICHD-III) criteria.Diagnostic accuracy of the instrument was tested throughconstruction of the Receiver Operator Curve.Results The Balkan Migraine Screening Questionnaire (BMSQ)instrument showed good diagnostic accuracy (sensitivity 83.4%and specificity 79.9%) for migraine without aura, with significantscreening yield among previously undiagnosed patients of 75.9%.The study also confirmed a high percentage of patients with hiddenmigraine without aura (MWA) (52.9%) revealed by the BMSQ andthe ICHD-III criteria that would otherwise remain undiagnosed.Conclusion The BMSQ is a valid and reliable clinical instrumentfor revealing migraine without aura, which could be easily selfadministeredby patients. It has high screening yield, discoveringmajority of patients with previously undiagnosed migraine withoutaura, whose definite diagnosis should later on be confirmedby the attending physicians using the ICHD-III criteria.