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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(04): 399-412
DOI: 10.1055/s-0042-1756490
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Validation studies on migraine diagnostic tools for use in nonclinical settings: a systematic review

Estudos de validação de ferramentas de diagnóstico de enxaqueca (migrânea) para uso em ambientes não clínicos: uma revisão sistemática
Du Wei 
1   Universiti Malaya, Faculty of Medicine, Department of Social and Preventive Medicine, Kuala Lumpur, Malaysia.
2   Guizhou Medical University, School of Medicine and Health Management, Guiyang, China.
,
Li Ping Wong 
1   Universiti Malaya, Faculty of Medicine, Department of Social and Preventive Medicine, Kuala Lumpur, Malaysia.
,
Tharani Loganathan 
1   Universiti Malaya, Faculty of Medicine, Department of Social and Preventive Medicine, Kuala Lumpur, Malaysia.
,
Rong-Rui Tang 
3   University-Town Hospital of Chongqing Medical University, Department of Neurosurgery, Chongqing, China.
,
Yue Chang
2   Guizhou Medical University, School of Medicine and Health Management, Guiyang, China.
,
Han-Ni Zhou 
2   Guizhou Medical University, School of Medicine and Health Management, Guiyang, China.
,
Mohammed K. A. Kaabar 
4   Universiti Malaya, Faculty of Science, Institute of Mathematical Sciences, Kuala Lumpur, Malaysia.
5   Washington State University, Pullman, Department of Mathematics and Statistics, Washington, United States.
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Abstract

Background Migraine underdiagnosis and undertreatment are so widespread, that hence is essential to diagnose migraine sufferers in nonclinical settings. A systematic review of validation studies on migraine diagnostic tools applicable to nonclinical settings can help researchers and practitioners in tool selection decisions.

Objective To systematically review and critically assess published validation studies on migraine diagnostic tools for use in nonclinical settings, as well as to describe their diagnostic performance.

Methods A multidisciplinary workgroup followed transparent and systematic procedures to collaborate on this work. PubMed, Medline, and Web of Science were searched for studies up to January 17, 2022. The QUADAS-2 was employed to assess methodological quality, and the quality thresholds adopted by the Global Burden Disease study were used to tail signaling questions.

Results From 7,214 articles identified, a total of 27 studies examining 19 tools were eligible for inclusion. There has been no high-quality evidence to support any tool for use of migraine diagnosis in nonclinical settings. The diagnostic accuracy of the ID-migraine, structured headache and HARDSHIP questionnaires have been supported by moderate-quality evidence, with sensitivity and specificity above 70%. Of them, the HARDSHIP questionnaire has been the most extensively validated. The remaining 16 tools have provided poor-quality evidence for migraine diagnosis in nonclinical populations.

Conclusions Up till now, the HARDSHIP questionnaire is the optimal choice for diagnosing migraine in nonclinical settings, with satisfactory diagnostic accuracy supported by moderate methodological quality. This work reveals the crucial next step, which is further high-quality validation studies in diverse nonclinical population groups.

Resumo

Antecedentes O sub-diagnóstico e o subtratamento da enxaqueca são tão difundidos que, portanto, é essencial para diagnosticar os portadores de enxaqueca em ambientes não-clínicos. Uma revisão sistemática dos estudos de validação das ferramentas de diagnóstico da enxaqueca aplicáveis a ambientes não-clínicos pode ajudar os pesquisadores e profissionais nas decisões de seleção de ferramentas.

Objetivo Revisar sistematicamente e avaliar criticamente estudos de validação publicados sobre ferramentas de diagnóstico da enxaqueca para uso em ambientes não-clínicos, bem como descrever seu desempenho diagnóstico.

Métodos Um grupo de trabalho multidisciplinar seguiu procedimentos transparentes e sistemáticos para colaborar neste trabalho. PubMed, Medline e Web of Science foram pesquisados por estudos até 17 de janeiro de 2022. O QUADAS-2 foi empregado para avaliar a qualidade metodológica, e os limites de qualidade adotados pelo estudo da Global Burden Disease foram usados para responder a questões de sinalização.

Resultados De 7.214 artigos identificados, um total de 27 estudos examinando 19 ferramentas foram elegíveis para inclusão. Não houve evidência de alta qualidade para apoiar qualquer ferramenta para o uso de diagnóstico de enxaqueca em ambientes não clínicos. A precisão diagnóstica do ID-Migraine, questionário de dor de cabeça estruturada e questionário HARDSHIP foram apoiados por evidências de qualidade moderada, com sensibilidade e especificidade acima de 70%. Deles, o questionário HARDSHIP foi o mais amplamente validado. As 16 ferramentas restantes forneceram provas de má qualidade para o diagnóstico de enxaqueca em populações não-clínicas.

Conclusões Até agora, o questionário HARDSHIP é a escolha ideal para o diagnóstico da enxaqueca em ambientes não-clínicos, com precisão diagnóstica satisfatória apoiada por uma qualidade metodológica moderada. Este trabalho revela o próximo passo crucial, que é a realização de mais estudos de validação de alta qualidade em diversos grupos populacionais não-clínicos.

Keywords

Migraine Disorders - Diagnosis - Sensitivity and Specificity - Systematic Review

Palavras-chave

Transtornos de Enxaqueca - Diagnóstico - Sensibilidade e Especificidade - Revisão Sistemática

Authors' Contributions

LPW, TL, DW: conceptualized the research framework and designed the methodology; DW, HNZ, RRT: conducted the literature search, screening, and review; DW, YC: appraised the quality of included studies; DW, MKAK: were involved in data extraction, assisted with the analysis and initial draft; LPW, TL: resolved any disagreements, did the manuscript correcting, language editing, and study supervision. The final submitted version has been read and approved by all authors.


Support

The study was supported financially by the Youth Science and Technology Talent Promotion Project of the Guizhou Educational Department, China (黔教合KY字[2022]241号).


Supplementary Material



Publication History

Received: 29 April 2022

Accepted: 29 July 2022

Article published online:
27 October 2022

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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