title: Field testing of the ICHD-3β and expert opinion criteria for chronic migraine.
abstract: BACKGROUND
  Chronic headache (CrH) occurs commonly in the population, and chronic migraine (CM) accounts for much of the CrH. Diagnostic criteria for CM remain controversial, and this could lead to undertreatment of CM. The purpose of this study was to analyze the clinical profiles of CM and to field test the International Classification of Headache Disorders-3β criteria (ICHD-3β) and Expert Opinion criteria (EO) for CM application.
  
  
  METHODS
  We retrospectively reviewed the medical records of CrH patients in our headache clinic during the period. Eligible patients were selected from CrH population based on Silberstein and Lipton criteria (S-L) for CM, and meanwhile fulfilled with migraine days at least 8 days/month. Then we evaluated the characteristics of clinic profiles and outcomes between patients diagnosed CM using ICHD-3β and EO criteria. Field tested the CM criteria Of ICHD-3β and EO.
  
  
  RESULTS
  In a total of 710 CrH patients , 261 (36.8 %) were recruited with CM based on both S-L criteria and fulfilled at least 8 migraine days/month. Be understandable, all the 261 patients met the EO criteria, and only 185 (70.9 %) met ICHD-3β for CM. For the 76 patients who met EO but not ICHD-3β, 70 had atypical migraine attacks (probable migraine, PM), and another 6 had typical migraine attacks but less than a total history of 5 attacks. Although 173 (66.3 %) were concurrent with medication overuse, just one patient overused triptans and none used ergot agents. Clinical features were not significantly different between the ICHD-3β and EO criteria groups (P > 0.05), and neither were outcomes of prophylaxis (P = 0.966). Total migraine prophylaxis effectiveness was 73 %.
  
  
  CONCLUSIONS
  Migraine-specific analgesics are rarely used in China, permitting patients with PM to avail themselves of "migraine days" is a reasonable accommodation for this difficult condition. In our hands, use of the new EO criteria for diagnosis of CM increases the sensitivity and maintains the specificity of decision making, and therefore should be adopted in CM management practice.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.
authors.forename: Huahua
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Deng
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.
authors.forename: Jieli
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.
authors.forename: Xueying
authors.initials: X
authors.lastname: Kong
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.
authors.forename: Qiuwen
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Department of Neurology, The first people's Hospital of Jintang County, Sichuan, China.
authors.forename: Kuiyun
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China. zheadache@163.com.
authors.forename: Jiying
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002681:China; D002908:Chronic Disease; D005260:Female; D051271:Headache Disorders, Secondary / Q000139:chemically induced / Q000145:classification*; D006801:Humans; D038801:International Classification of Diseases / Q000145:classification*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000145:classification* / Q000188:drug therapy; D012189:Retrospective Studies; D055815:Young Adult
keywords: Chronic disease; Humans; International classification of diseases; Migraine disorders/classifications; Migraine disorders/diagnosis