Evidence map›Paper›PMID 39463026›Full record

ArticleHeadache

A critical appraisal of the International Classification of Headache Disorders migraine diagnostic criteria based on a retrospective multicenter cross-sectional headache registry study in youth.

Carlyn Patterson Gentile, Andrew D Hershey, Christina L Szperka

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Headache. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Carlyn Patterson GentileDivision of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-4996-2457
Andrew D HersheyDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.ORCID 0000-0002-1598-7536
Christina L SzperkaDivision of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Funding

Trigeminovascular sensitization in post-traumatic headache: electrophysiologic and blood biomarkers in youthK23NS124986 · NINDS · CHILDREN'S HOSP OF PHILADELPHIA · PI Carlyn Anne Patterson Gentile · 2022 to 2026
$1.0M
Occipital Nerve Blocks for Acute Treatment of Pediatric MigraineK23NS102521 · NINDS · CHILDREN'S HOSP OF PHILADELPHIA · PI SZPERKA, CHRISTINA LYNCH · 2018 to 2022
$940k
National Institute of Neurological Disorders and Stroke (NINDS) K23NS102521National Institute of Neurological Disorders and Stroke (NINDS) K23NS124986NINDS NIH HHS K23 NS102521NINDS NIH HHS K23 NS124986Pfizer
6 · The paper itself

Abstract

objectivesWe used Cluster Analysis of Migraine-associated Symptoms (CAMS) to critically evaluate current International Classification of Headache Disorders-Third Edition (ICHD-3) migraine-associated symptoms criteria.

backgroundDiagnostic criteria play a central role in guiding clinical trial inclusion, and therefore available treatments. Migraine and tension-type headaches (TTH) are differentiated in ICHD-3 by many headache characteristics, including associated symptoms. A diagnosis of probable migraine indicates some but not all features of migraine are met. Photophobia and phonophobia, or nausea and/or vomiting, are required to meet a diagnosis of migraine; however, CAMS-a model that describes associated symptoms across youth with headache-indicates that a broader range of symptoms contain information about migraine burden.

methodsIn this multisite retrospective cross-sectional study, we evaluated ICHD-3 migraine criteria. Youth aged 6-17 years with migraine (including probable migraine) or TTH were included in the analysis. We used CAMS to evaluate the migraine-associated symptom criterion. With CAMS as a guide, we evaluated how changes to the migraine-associated symptom criterion altered who met the diagnosis of migraine.

resultsOf the 9017 participants included in this study, 66.7% were female and had a median (interquartile range) age of 13 (10-15) years. Most participants had migraine or probable migraine (99.0%), and the remainder had TTH (1.0%). A sizable percentage (10.1%) of youth under the umbrella diagnosis of migraine were diagnosed with probable migraine because they did not meet migraine-associated symptom criterion D; however, many in this group reported several non-ICHD migraine-associated symptoms. We explored alterations to criterion D based on CAMS. Allowing for photophobia or phonophobia re-categorized 55.6% of youth as having migraine, though some only had one symptom. Including lightheadedness or lightheadedness and spinning re-categorized 19.7% and 25.8% of youth with migraine, respectively, but all of those who were re-categorized had at least two migraine-associated symptoms.

conclusionThe ICHD-3 captures the most prevalent migraine-associated symptoms; however, many youths with probable migraine who do not meet full criteria due to insufficient associated symptoms nonetheless experience multiple non-ICHD migraine-associated symptoms. Changes to criterion D should be considered for the ICHD-4.

Indexed as

International Classification of DiseasesMigraine DisordersRegistriesAdolescentChildCluster AnalysisCross-Sectional StudiesFemaleHumansMaleRetrospective StudiesTension-Type Headachedizzinessheadache‐associated symptomsICHDpediatricvestibular

Identifiers

PMID39463026
PMCPMC11560481

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.