Diagnostic Accuracy of the ID Migraine: A Systematic Review and Meta-Analysis

Authors

  • Gráinne Cousins MSc, PhD,

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  • Samira Hijazze BSc,

    1. From the HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland (G. Cousins, S. Hijazze, and T. Fahey); Department of Primary and Community Care, Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands (S. Hijazze, and F.A. Van de Laar).
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  • Floris A. Van de Laar MD, PHD,

    1. From the HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland (G. Cousins, S. Hijazze, and T. Fahey); Department of Primary and Community Care, Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands (S. Hijazze, and F.A. Van de Laar).
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  • Tom Fahey MSc, MD, FRCGP

    1. From the HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland (G. Cousins, S. Hijazze, and T. Fahey); Department of Primary and Community Care, Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands (S. Hijazze, and F.A. Van de Laar).
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  • Funding sources: This work was supported by the Health Research Board of Ireland through the HRB Centre for Primary Care Research under Grant HRC/2007/1. In addition, S. H. was funded as part of an Erasamus Exchange Student Research Fellowship between RU Nijmegen Medical School and RCSI Medical School, Dublin.

  • Conflict of Interest: No conflict

G. Cousins, HRB Centre for Primary Care Research – Division of Population Health Sciences, Royal College of Surgeons in Ireland 123 Stephen's Green Dublin 2, Ireland. Email: gcousins@rcsi.ie

Abstract

(Headache 2011;51:1140-1148)

Objective.— The purpose of this systematic review with meta-analysis is to determine the diagnostic accuracy of the identification of migraine (ID Migraine) as a decision rule for identifying patients with migraine.

Background.— The ID Migraine screening tool is designed to identify patients with migraine in primary care settings. Several studies have validated the ID Migraine across various clinical settings, including primary care, neurology departments, headache clinics, dental clinics, ear, nose, and throat (ENT) and ophthalmology.

Methods.— A systematic literature search was conducted to identify all studies validating the ID Migraine, with the International Headache Criteria as the reference standard. The methodological quality of selected studies was assessed using the Quality of Diagnostic Accuracy Studies tool. All selected studies were combined using a bivariate random effects model. A sensitivity analysis was also conducted, pooling only those studies using representative patient groups (primary care, neurology departments, and headache clinics) to determine the potential influence of spectrum bias on the results.

Results.— Thirteen studies incorporating 5866 patients are included. The weighted prior probability of migraine across the 13 studies is 59%. The ID Migraine is shown to be useful for ruling out rather than ruling in migraine, with a greater pooled sensitivity estimate (0.84, 95% confidence interval 0.75-0.90) than specificity (0.76, 95% confidence interval 0.69-0.83). A negative ID Migraine score reduces the probability of migraine from 59% to 23%. The sensitivity analysis reveals similar results.

Conclusions.— This systematic review quantifies the diagnostic accuracy of the ID Migraine as a brief, practical, and easy to use diagnostic tool for Migraine. Application of the ID Migraine as a diagnostic tool is likely to improve appropriate diagnosis and management of migraine sufferers.

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