Diagnostic accuracy of the ID-Migraine: a systematic review.
Objective: The purpose of this systematic review with meta-analysis is to determine the diagnostic accuracy of the 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, ENT and primary care settings. Several studies have validated the ID Migraine across various clinical settings, including primary care, neurology departments, headache clinics, dental clinics, ENT and ophthalmology.
Method: 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 5,866 patients are included. The weighted prior probability of migraine across the thirteen 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% CI 0.75 – 0.90) than specificity (0.76, 95% CI 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 quantifes 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.