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A possible role of ID-Migraine™ in the emergency department: study of an emergency department out-patient population

Authors

  • C Mostardini,

    1. Emergency Department Headache Centre, ‘Enzo Borzomati’ Pain Centre, Emergency Department, Azienda Policlinico Umberto I, ‘Sapienza’ University, Rome, Italy
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  • VC D'Agostino,

    1. Emergency Department Headache Centre, ‘Enzo Borzomati’ Pain Centre, Emergency Department, Azienda Policlinico Umberto I, ‘Sapienza’ University, Rome, Italy
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  • DE Dugoni,

    1. Emergency Department Headache Centre, ‘Enzo Borzomati’ Pain Centre, Emergency Department, Azienda Policlinico Umberto I, ‘Sapienza’ University, Rome, Italy
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  • R Cerbo

    1. Emergency Department Headache Centre, ‘Enzo Borzomati’ Pain Centre, Emergency Department, Azienda Policlinico Umberto I, ‘Sapienza’ University, Rome, Italy
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Dr Claudio Mostardini, ‘Enzo Borzomati’ Pain Centre, Emergency Department, ‘Sapienza’ University, Viale del Policlinico 135, 00185, Rome, Italy. Tel. + 39-06-4991-9190, fax + 39-06-4991-9191, e-mail claudio.mostardini@uniroma1.it

Abstract

Mostardini C, d'Agostino VC, Dugoni DE & Cerbo R. A possible role of ID-Migraine™ in the emergency department: study of an emergency department out-patient population. Cephalalgia 2009. London. ISSN 0333-1024

Headache symptoms account for 1–3% of admissions to an emergency department (ED). Most patients affected by a primary headache (PH) have migraine, although they are often misdiagnosed as ‘headache not otherwise specified’. We investigated the possibility of using ID-Migraine (ID-M) to improve migraine recognition in the ED setting. We planned a pilot study involving ED out-patients with a diagnosis of PH. Diagnoses of a blinded headache expert were subsequently matched with the ID-M results. We tested ID-M on 230 patients (199 PH, 31 secondary headaches). Considering only PH, ID-M exhibited a sensitivity of 0.94 and specificity of 0.83 with a positive predictive value (PPV) of 0.99. The ID-M is a simple migraine screener with high sensitivity, high specificity and high PPV, even in an ED-derived population. Methodical use of this tool in an ED setting may, once a secondary headache has been excluded, lead to rapid diagnosis of migraine.

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