OBJECTIVE: To develop a reliable and valid tool to screen for chronic migraine (CM) amongst individuals with severe headaches. BACKGROUND: Despite its substantial economic and quality of life burden, CM remains under-recognized, under-treated and poorly managed. No validated screening tool exists for identifying individuals in the headache population who likely have CM. DESIGN/METHODS: The item pool for ID-CM was derived from existing instruments and candidate questions proposed by a Delphi panel composed of eight international headache experts. A draft questionnaire of 20-items was developed based on psychometric modeling in available data, Delphi panel input, and cognitive debriefing interviews among ten persons with CM. The draft screening tool was administered to an online research panel of severe headache sufferers. Exploratory factor analysis (EFA) was used to determine factor structure. Multiple group IRT models (stratified on headache type: CM, EM, severe headache) explored item properties and homogeneity of item properties across headache strata. Analyses were conducted using M-plus version 7.1. RESULTS: The draft screener was administered to 1562 persons having CM (n=363), EM (n=416) and other severe headache (n=783). Model fit indicated that a 3-factor solution optimally explained the data with factors corresponding to migraine symptoms (6-items, e.g. pain intensity, nausea), headache-related disability (3-items from MIDAS) and disruption of daily activities (3 items, e.g. headache interference with planning). Multiple group multi-factor IRT models revealed homogeneity of screener items across headache types. Factor correlations were strong: disruption and disability were correlated 0.7, disruption and symptoms correlated 0.4, and disability and symptoms correlated 0.3. CONCLUSIONS: A preliminary tool has been developed to screen for chronic migraine amongst individuals with severe headache. Test-retest reliability and validation research is ongoing. In the next phase, screening diagnoses will be compared with clinical expert diagnosis using structured interviews. Study Supported by: Allergan, Inc. Disclosure: Dr Lipton has received personal compensation for activities with Allergan, American Headache Society, Autonomic Technologies, Boston Scientific, Bristol-Myers Squibb Company, Cognimed, Colucid, Eli Lilly & Company, eNeura Therapeutics, GlaxoSmithKline, Inc., MAP Pharmaceuticals, Merck, Nautilus Neuroscience, Novartis, NuPathe, Vedanta, and Zogenix. Dr. Lipton holds stock and/or stock options in eNeura Therapeutics. Dr. Serrano has received research support from Allergan, Inc. Dr. Blumenfeld has received personal compensation for activities with Pfizer Inc., Allergan Inc., Medtronic Inc., Merck & Co. Inc., Forest, and Keller Laboratories. Dr. Blumenfeld has received research support from Allergan Inc., Medtronic Inc., GlaxoSmithKline Inc., and Keller Laboratories. Dr. Dodick has received personal compensation for activities with Allergan, Inc., Pfizer Inc., Merck & Co., Inc., ENeura NuPathe, Colucid, Alder, Artaeus, Eli Lilly & Company, Amgen Inc., WL Gore, Bristol-Myers Squibb Company, Ethicon J&J, ATI, Zogenix, Cognimed, Intramed, Scientiae, Syndergy, Curatio CME, and Pfizer Inc. Dr. Dodick has received personal compensation in an editorial capacity for Sage Publishing, Lippincott, Oxford University Press, Cambridge University Press, UpToDate, and Web MD. Dr. Aurora has received personal compensation for activities with Merck & Co., Inc., Allergan, Inc., and eNeura. Dr. Aurora has received research support from Merck & Co., Inc., Allergan, Inc., and eNeura. Dr. Becker has received personal compensation for activities with Allergan Inc., St. Jude Medical Center, Tribute Pharmaceuticals, Amgen Inc., Electrocore Inc., and Serono Inc. Dr. Becker has received research support from St. Jude Medical Center. Dr. Diener has received personal compensation for activities with Merck & Co., Inc. Allergan, Inc., Electrocore, Amgen Inc., and Novartis. Dr. Diener has received research support from Merck & Co., Inc., Allergan, Inc., Weber & Weber, and Electrocore. Dr. Wang has received personal compensation for activities with Allergan Inc., GlaxoSmithKline Inc., Pfizer Inc., and Eli Lilly & Co. Dr. Wang has received research support from Novartis. Dr. Vincent has nothing to disclose. Dr. Buse has received personal compensation for activities with Allergan Inc., and Zogenix. Dr. Buse has received research support from Allergan Inc., Merck & Co. Inc., and Zogenix. Dr. Sanderson has received personal compensation for activities with Allergan Inc. Dr. Sanderson has received research support from Allergan Inc. Dr. Varon has received personal compensation for activities with Allergan Inc. Dr. Varon holds stock and/or stock options in Allergan Inc., which sponsored research in which Dr. Varon was involved as an investigator. Dr. Reed has received research support from Allergan Inc., ENDO, Merck & Co. Inc., GlaxoSmithKline Inc., MAP Pharmaceuticals, Novartis, NuPathe, CoLucid, and the National Headache Foundation.

Letter to the Editor Sublingual Feverfew/Ginger (LipiGesic M) Reanalysis of Data Roger Cady MD, Roger Cady MD Headache Care Center – Medicine, Springfield, MO, USASearch for more papers by this authorDaniel Serrano PhD, Daniel Serrano PhD Vedanta – Research, Chapel Hill, NC, USASearch for more papers by this authorRichard Lipton MD, Richard Lipton MD Albert Einstein College of Medicine – Neurology, Bronx, NY, USASearch for more papers by this authorRebecca Browning BS, Rebecca Browning BS Clinvest Inc – Statistics, Springfield, MO, USASearch for more papers by this author Roger Cady MD, Roger Cady MD Headache Care Center – Medicine, Springfield, MO, USASearch for more papers by this authorDaniel Serrano PhD, Daniel Serrano PhD Vedanta – Research, Chapel Hill, NC, USASearch for more papers by this authorRichard Lipton MD, Richard Lipton MD Albert Einstein College of Medicine – Neurology, Bronx, NY, USASearch for more papers by this authorRebecca Browning BS, Rebecca Browning BS Clinvest Inc – Statistics, Springfield, MO, USASearch for more papers by this author First published: 22 February 2013 https://doi.org/10.1111/j.1526-4610.2012.02282.xCitations: 1 Conflict of Interest: Roger Cady has served as a consultant for GlaxoSmithKline, Merck, and Ortho-McNeil, and received research grants from Allergan, Endo Pharmaceuticals, GlaxoSmithKline, Merck, PuraMed Bioscience, and Wyeth. Authors Daniel Serrano, Richard Lipton, and Rebecca Browning have nothing to disclose in relation to this letter to the editor. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1 Cady RK, Goldstein J, Nett R, Mitchell R, Beach ME, Browning R. A double-blind, placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache. 2011; 7: 1078-1086. 2 Satterthwaite FE. Approximate distribution of estimates of variance components. Biometrics. 1946; 2: 110-114. 3 Kenward MG, Roger JH. Small sample inference for fixed effects from restricted maximum likelihood. Biometrics. 1997; 53: 983-997. 4 McCullagh P, Nelder JA. Generalized Linear Models, 2nd edn. Boca Raton, FL: Chapman & Hall/CRC; 1989. 5 Demidenko E. Mixed Models: Theory and Applications. New York, NY: John Wiley & Sons; 2004. 6 Agresti A. Categorical Data Analysis, 2nd edn. New York, NY: John Wiley & Sons; 2002. Citing Literature Volume53, Issue2February 2013Pages 384-386 ReferencesRelatedInformation