From the Guidelines
The most effective medical tool for collecting a history on patients with headaches is the combination of a clinical interview and standardized questionnaires, such as the Migraine Screen Questionnaire (MS-Q) or the ID-Migraine questionnaire, as supported by the study published in Nature Reviews Neurology in 2021 1. This approach allows for a comprehensive understanding of the patient's headache characteristics, triggers, and impact on daily functioning. The clinical interview should include questions about:
- Headache characteristics (location, intensity, duration, frequency)
- Onset timing
- Triggers
- Associated symptoms
- Impact on daily functioning Standardized questionnaires like the MS-Q or ID-Migraine can help quantify headache burden and classify headache types. Additionally, headache diaries or calendars can be used to track headaches over time, documenting frequency, intensity, triggers, and medication use. Pain scales such as the Visual Analog Scale (VAS) or Numeric Rating Scale (NRS) can help quantify pain intensity. Screening tools for comorbidities like the Patient Health Questionnaire (PHQ-9) for depression or the Generalized Anxiety Disorder (GAD-7) scale may be useful since psychological conditions often accompany headaches. These tools collectively provide a comprehensive picture of the patient's headache condition, enabling more accurate diagnosis and personalized treatment planning, as noted in the study published in JAMA Neurology in 2020 1. It is essential to prioritize the single most recent and highest quality study, which in this case is the 2021 study published in Nature Reviews Neurology 1, to ensure that the recommended tools are evidence-based and effective in improving patient outcomes.
From the Research
Medical Tools for Collecting Patient History
There are several medical tools available to collect a history on patients with headaches. These tools include:
- Diagnostic headache diaries, which can be used by patients to record their headache attacks and medication consumption on a day-to-day basis 2, 3
- Basic diagnostic headache diaries (BDHD), which have been shown to be well accepted and useful in the diagnosis of headache 3
- Clinical interviews, which can be used in combination with diagnostic headache diaries to assess headache diagnosis 4, 5
- Questionnaires, which can be used to estimate headache frequency, intensity, and duration, although they may be less accurate than headache diaries 6
Characteristics of Medical Tools
These medical tools have several characteristics that make them useful for collecting patient history, including:
- The ability to record headache attacks and medication consumption over time 2, 3
- The ability to provide a complete and accurate diagnosis of headache disorders 3, 5
- The ability to identify coexisting headache disorders and distinguish between different types of headaches 3, 5
- The ability to be used in combination with other diagnostic tools, such as clinical interviews and questionnaires 4, 5
Effectiveness of Medical Tools
Studies have shown that these medical tools can be effective in collecting patient history and diagnosing headache disorders. For example:
- The BDHD has been shown to be well accepted and useful in the diagnosis of headache, with a high level of agreement between diary and clinical diagnoses 3
- The use of a diagnostic diary and clinical interview has been shown to be more effective than clinical interview alone in assessing headache diagnosis 5
- Patient estimations of headache frequency and duration by questionnaire have been shown to be reasonably accurate, although headache intensity may be more difficult to remember and report 6