title: Validation of The 3-Question Headache Screen in The Diagnosis of Migraine in Nigeria.
abstract: BACKGROUND
  Migraine is a chronic episodic disorder that is still under-diagnosed and undertreated. A rapid diagnostic method is desirable so that treatment can be initiated early. We compared the 3-question headache screen with the International Headache Society (IHS) criteria in the diagnosis of migraine among Nigerians.
  
  
  METHODS
  Using a multi-stage sampling technique, 1513 respondents were screened for migraine using both the IHS criteria and the 3-question headache screen. A statistical comparison of the two diagnostic methods was then done by determination of kappa coefficient, sensitivity and specificity.
  
  
  RESULTS
  The prevalence of migraine obtained using the IHS criteria was 9.6% (95% CI, 8.1%-11.1%) while it was 8.3% (95% CI, 8.1%-8.5%) with the use of the 3-question headache screen. There was a good agreement between the IHS criteria and the 3-question headache screen (k=0.68, p<0.001). The 3-question headache screen had a sensitivity of 66.2% (95% CI, 58.5%-73.9%), specificity of 97.8% (95% CI, 97.0%-98.6%), positive predictive value of 76.2% (95% CI, 68.8%-83.6%) and a negative predictive value of 96.5% (95% CI, 95.5%-97.5%).
  
  
  CONCLUSIONS
  The 3-question headache screen is sensitive and specific in making a rapid diagnosis of migraine among Nigerians. Its use is thus encouraged so that appropriate management of the condition can be initiated early in order to reduce associated disability.
authors.affiliation: Division of Neurology, Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Kolawole
authors.initials: K
authors.lastname: Wahab
authors.affiliation: Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria.
authors.forename: Asuwemhe
authors.initials: A
authors.lastname: Ugheoke
authors.affiliation: Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria.
authors.forename: Peter
authors.initials: P
authors.lastname: Okokhere
authors.affiliation: Department of Otorhinolaryngology, University of Abuja, Abuja, Nigeria.
authors.forename: Titus
authors.initials: T
authors.lastname: Ibekwe
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000175:diagnosis; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology; D009549:Nigeria / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: 3-question headache screen; Diagnosis; Migraine; Nigeria; Validation