The validity of questionnaire-based diagnoses: the third Nord-Trøndelag Health Study 2006-2008.
The Nord-Trøndelag Health Study (HUNT 3) performed in 2006-2008 is a replication of the cross-sectional survey from 1995 to 1997 (HUNT 2). The aim of the present study was to assess the sensitivity and specificity of questionnaire-based headache diagnoses using a personal interview by a neurologist as a gold standard. For the questionnaire-based status as headache sufferer, a sensitivity of 88%, a specificity of 86%, and a kappa statistic of 0.70 were found. Chronic headache, chronic tension-type headache (TTH), and medication overuse headache (MOH) were diagnosed with a specificity of > or =99%, and a kappa statistic of > or =0.73. Lower figures were found for the diagnoses of migraine and TTH. For individuals with headache > or =1 day per month, a sensitivity of 58% (migraine) and 96% (TTH), a specificity of 91 and 69%, and a kappa statistic of 0.54 and 0.44 were found, respectively. The specificity for migraine with aura was 95%. In conclusion, the HUNT 3-questionnaire is a valid tool for identifying headache sufferers, and diagnosing patients with chronic headache, including chronic TTH and MOH. The more moderate sensitivity for migraine and TTH makes the questionnaire-based diagnoses of migraine and TTH suboptimal for determining the prevalence. However, the high specificity of the questionnaire-based diagnosis of migraine, in particular for migraine with aura, makes the questionnaire a valid tool for diagnosing patients with migraine for genetic studies.
Hagen
Knut
K
Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway. knut.hagen@ntnu.no
Zwart
John-Anker
JA
Aamodt
Anne Hege
AH
Nilsen
Kristian Bernhard
KB
Bråthen
Geir
G
Helde
Grethe
G
Stjern
Marit
M
Tronvik
Erling A
EA
Stovner
Lars Jacob
LJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D020773:Headache Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis; D009664:Norway / Q000453:epidemiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult