A possible role of ID-Migraine in the emergency department: study of an emergency department out-patient population.
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.
Emergency Department Headache Centre, Enzo Borzomati Pain Centre, Azienda Policlinico Umberto I, Sapienza University, Rome, Italy. claudio.mostardini@uniroma1.it
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d'Agostino
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Dugoni
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D000328:Adult; D003937:Diagnosis, Differential; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis*; D010045:Outpatients; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult