Revista de neurologia · 2003
[The validity of the International Headache Society criteria and the modifications put forward in 2002 in the diagnosis of migraine and tension type headaches].
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Cano-García F J, Rodríguez-Franco L
Аннотация
INTRODUCTION: The diagnosis of migraine (M) and tension type headaches (TH) is clinical; it is therefore important to refine the diagnostic criteria. The International Headache Society (IHS) set out the currently used criteria in 1988; 14 years later it has just put forward a number of modifications.
AIMS: Our aim was to test the comprehensiveness, sensitivity and specificity of both the current and the newly proposed diagnostic criteria in Primary Health Care (PHC), where patients must be screened properly before referral to Neurology services.
PATIENTS AND METHODS: 74 cases of M and 44 of TH attended in two PHC centres in Seville, in the course of a study about the psychological aspects of headaches. The doctors used a semi structured clinical interview based on the IHS criteria to carry out diagnoses.
RESULTS: The comprehensiveness of the system was 100%; sensitivity and specificity of the diagnostic criteria were, generally speaking, appropriate and one point highlighted was the intensity of the pain and the fact that it was aggravated by physical activity. Discriminating analysis correctly classified 94.1% of the cases according to the 1988 IHS criteria and 90.7% according to the IHS proposals from 2002, although in the latter case an extra criterion was included in the discrimination.
DISCUSSION: As shown by different studies, diagnosis carried out by professionals who are well trained in the use of the current IHS criteria is perfectly valid. The present proposals for modification seem to reorganise the classification more efficiently, since they include chronic migraine and also divide episodic TH into infrequent and frequent bouts. These new proposals are now beginning their test period in different fields of application.
AIMS: Our aim was to test the comprehensiveness, sensitivity and specificity of both the current and the newly proposed diagnostic criteria in Primary Health Care (PHC), where patients must be screened properly before referral to Neurology services.
PATIENTS AND METHODS: 74 cases of M and 44 of TH attended in two PHC centres in Seville, in the course of a study about the psychological aspects of headaches. The doctors used a semi structured clinical interview based on the IHS criteria to carry out diagnoses.
RESULTS: The comprehensiveness of the system was 100%; sensitivity and specificity of the diagnostic criteria were, generally speaking, appropriate and one point highlighted was the intensity of the pain and the fact that it was aggravated by physical activity. Discriminating analysis correctly classified 94.1% of the cases according to the 1988 IHS criteria and 90.7% according to the IHS proposals from 2002, although in the latter case an extra criterion was included in the discrimination.
DISCUSSION: As shown by different studies, diagnosis carried out by professionals who are well trained in the use of the current IHS criteria is perfectly valid. The present proposals for modification seem to reorganise the classification more efficiently, since they include chronic migraine and also divide episodic TH into infrequent and frequent bouts. These new proposals are now beginning their test period in different fields of application.