Diagnostic and classification tools for chronic headache disorders: A systematic review

Abstract

Background or aim Despite guidelines and the International Classification of Headache Disorders (ICHD-III beta) criteria, the diagnosis of common chronic headache disorders can be challenging for non-expert clinicians. The aim of the review was to identify headache classification tools that could be used by a non-expert clinician to classify common chronic disorders in primary care. Methods We conducted a systematic literature review of studies validating diagnostic and classification headache tools published between Jan 1988 and June 2016 from key databases: MEDLINE, ASSIA, Embase, Web of Knowledge and PsycINFO. Quality assessment was assessed using items of the Quality of Diagnostic Accuracy Studies (QUADAS-2). Results The search identified 38 papers reporting the validation of 30 tools designed to diagnose, classify or screen for headache disorders; nine for multiple headache types, and 21 for one headache type only. We did not identify a tool validated in a primary care that can be used by a non-expert clinician to classify common chronic headache disorders and screen for primary headaches other than migraine and tension-type headache in primary care. Conclusions Despite the availability of many headache classification tools we propose the need for a tool that could support primary care clinicians in diagnosing and managing chronic headache disorders within primary care, and allow more targeted referral to headache specialists.

Current clinical practice in disabling and chronic migraine in the primary care setting: results from the European My-LIFE anamnesis survey

“…Effective management of migraine needs to consider the impact on the patient’s life and lifestyle to establish the best treatment. In primary care, up to 18 scales are used to classify or screen for migraine [ 25 ]. Although most of the tools are quick, easy-to-use, self-completed screening questionnaires, their use is not widely widespread.…”

“…The most widely used tool at the first visit was ID-Migraine (63% of participants). This scale has been validated in different languages and settings and is common among GPs [ 25 – 28 ]. Interestingly, 59% of participants from Italy were using the ID-CM at the first visit, which perhaps could be explained by the recent translation and validation of this scale into Italian [ 29 ].…”

Need of guidance in disabling and chronic migraine identification in the primary care setting, results from the european MyLife anamnesis survey

“…In our project, 95% of GPs considered helpful or mandatory the use of an anamnesis guide for patients with headache disorders. Diagnosis and management of headache disorders can be challenging for non-expert physicians [ 10 ]. A comprehensive tool to help diagnose headache disorders, in particular chronic headache disorders, has been lacking [ 10 ].…”

“…Diagnosis and management of headache disorders can be challenging for non-expert physicians [ 10 ]. A comprehensive tool to help diagnose headache disorders, in particular chronic headache disorders, has been lacking [ 10 ]. Several tools to help in the identification of migraine and CM (e.g., ID-Migraine [ 33 ], ID-CM [ 34 ]) are available; however, the majority of them are self-administered questionnaires that do not include warning features, referral recommendations or tools to assess impact of migraine on patients’ lives [ 10 ].…”

“…Accurate diagnosis of headache disorders can be challenging for non-specialists clinicians [ 10 ]. Despite being one of the most common reasons for visits to primary care [ 11 ], formal training on recognition and management of headache disorders for general practitioners (GPs) is limited [ 12 ].…”