PedMIDAS-Based Scoring Underestimates Migraine Disability on Non-School Days

Authors

  • Geoffrey L. Heyer MD,

    Corresponding author
    1. Departments of Pediatrics and Neurology, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
    • Address all correspondence to G.L. Heyer, Departments of Pediatrics and Neurology, Nationwide Children's Hospital and The Ohio State University, 700 Children's Drive, ED-5, Columbus, OH 43205, USA.

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  • Kelsey Merison MD,

    1. Departments of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
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  • Sean C. Rose MD,

    1. Departments of Pediatrics and Neurology, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
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  • Sara Q. Perkins,

    1. Center for Human Psychophysiology, Miami University, Oxford, OH, USA
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  • JoEllen M. Lee CNP,

    1. Departments of Pediatrics and Neurology, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
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  • William C.L. Stewart PhD

    1. Departments of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
    2. Statistics Department, The Ohio State University, Columbus, OH, USA
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  • Funding: This work was supported by a Nationwide Children's Hospital Intramural Grant [Grant #278311; GL Heyer].
  • Conflicts of Interest: None.

Abstract

Objective

The aim of this study is to compare daily Pediatric Migraine Disability Assessment (PedMIDAS)-based scores for headaches occurring on school days vs non-school days and during the school year vs the summer holiday.

Background

The PedMIDAS is the only instrument validated to assess migraine disability among school-aged children. However, the PedMIDAS may underestimate disability during prolonged school holidays.

Methods

In a prospective cohort study, migraine patients aged 10–18 years completed a 90-day Internet-based headache diary. For each headache day, they answered PedMIDAS-based questions and rated their headache intensity (scale 1–10). PedMIDAS-based scores, headache intensity ratings, and relative headache frequencies were compared for school days vs non-school days and for the school year vs the summer holiday.

Results

Fifty-two patients completed 4680 diary entries comprising 984 headache days. The headache frequencies and intensity ratings did not differ between time periods. However, the mean headache disability scores (as measured from PedMIDAS-based questions) were significantly different for school days (0.85) compared to non-school days (0.45), P < .001, and for the school year (0.73) compared to the summer holiday (0.46), P < .016.

Conclusion

Given similar headache intensities and frequencies, daily PedMIDAS-based scores significantly underestimate headache disability on non-school days. Accordingly, PedMIDAS scoring during the school year may not be comparable to assessments done during the summer holiday. These potential differences must be considered when using the instrument as an outcome measure for clinical trials.

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