三问题头痛筛查在尼日利亚偏头痛诊断中的验证

Validation of The 3-Question Headache Screen in The Diagnosis of Migraine in Nigeria.

作者信息

Wahab Kolawole, Ugheoke Asuwemhe, Okokhere Peter, Ibekwe Titus

机构信息

Division of Neurology, Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria.

出版信息

Ethiop J Health Sci. 2016 Jan;26(1):5-8. doi: 10.4314/ejhs.v26i1.3.

DOI:10.4314/ejhs.v26i1.3

PMID:26949310

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4762953/

Abstract

BACKGROUND

Migraine is a chronic episodic disorder that is still under-diagnosed and undertreated. A rapid diagnostic method is desirable so that treatment can be initiated early. We compared the 3-question headache screen with the International Headache Society (IHS) criteria in the diagnosis of migraine among Nigerians.

METHODS

Using a multi-stage sampling technique, 1513 respondents were screened for migraine using both the IHS criteria and the 3-question headache screen. A statistical comparison of the two diagnostic methods was then done by determination of kappa coefficient, sensitivity and specificity.

RESULTS

The prevalence of migraine obtained using the IHS criteria was 9.6% (95% CI, 8.1%-11.1%) while it was 8.3% (95% CI, 8.1%-8.5%) with the use of the 3-question headache screen. There was a good agreement between the IHS criteria and the 3-question headache screen (k=0.68, p<0.001). The 3-question headache screen had a sensitivity of 66.2% (95% CI, 58.5%-73.9%), specificity of 97.8% (95% CI, 97.0%-98.6%), positive predictive value of 76.2% (95% CI, 68.8%-83.6%) and a negative predictive value of 96.5% (95% CI, 95.5%-97.5%).

CONCLUSION

The 3-question headache screen is sensitive and specific in making a rapid diagnosis of migraine among Nigerians. Its use is thus encouraged so that appropriate management of the condition can be initiated early in order to reduce associated disability.

摘要

背景

偏头痛是一种慢性发作性疾病，目前仍存在诊断不足和治疗不足的情况。因此需要一种快速诊断方法，以便能尽早开始治疗。我们比较了三问题头痛筛查法与国际头痛协会（IHS）标准在尼日利亚人偏头痛诊断中的应用。

方法

采用多阶段抽样技术，使用IHS标准和三问题头痛筛查法对1513名受访者进行偏头痛筛查。然后通过确定kappa系数、敏感性和特异性对两种诊断方法进行统计学比较。

结果

采用IHS标准得出的偏头痛患病率为9.6%（95%置信区间，8.1%-11.1%），而使用三问题头痛筛查法得出的患病率为8.3%（95%置信区间，8.1%-8.5%）。IHS标准与三问题头痛筛查法之间存在良好的一致性（k = 0.68，p < 0.001）。三问题头痛筛查法的敏感性为66.2%（95%置信区间，58.5%-73.9%），特异性为97.8%（95%置信区间，97.0%-98.6%），阳性预测值为76.2%（95%置信区间，68.8%-83.6%），阴性预测值为96.5%（95%置信区间，95.5%-97.5%）。