偏头痛致残评估量表（MIDAS）的最小有意义差异：来自 DMKG 头痛登记处的纵向数据。

Minimal important difference of the Migraine Disability Assessment (MIDAS): Longitudinal data from the DMKG Headache Registry.

机构信息

Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany.

German Migraine and Headache Society, Frankfurt, Germany.

出版信息

Cephalalgia. 2024 Jul;44(7):3331024241261077. doi: 10.1177/03331024241261077. Epub 2024 Jul 21.

DOI:10.1177/03331024241261077

PMID:39033424

Abstract

BACKGROUND

The Migraine Disability Assessment (MIDAS) is widely used. However, there are limited data on how much a reduction in the MIDAS score indicates a change that matters to the patient.

METHODS

Data from the DMKG (i.e. German Migraine and Headache Society) Headache Registry were used to determine the minimal important difference (MID) of the MIDAS, using the Patient Global Impression of Change (PGIC) as anchor and applying average change and receiver operating characteristic curve methods.

RESULTS

In total, 1218 adult migraine patients (85.6% female, 40.2 ± 12.8 years, baseline MIDAS 44.2 ± 47.4, follow-up MIDAS 36.5 ± 45.3) were included. For patients with baseline MIDAS >20 (MIDAS grade IV, n = 757), different methods using PGIC "somewhat improved" as anchor yielded percent change MIDs of the MIDAS between -29.4% and -33.2%. For baseline MIDAS between 6 and 20 (grades II and III, n = 334), using PGIC "much improved" as anchor, difference change MIDs were between -3.5 and -4.5 points.

CONCLUSIONS

Based on the above results, we estimated the MID of the MIDAS at -30% for patients with a baseline MIDAS >20, and at -4 points for those with a baseline MIDAS of 6-20, for a tertiary headache care population.

TRIAL REGISTRATION

The DMKG Headache Registry is registered with the German Clinical Trials Register (DRKS 00021081).

摘要

背景

偏头痛残疾评估（MIDAS）被广泛应用。然而，关于 MIDAS 评分降低多少才能对患者产生重要变化，目前数据有限。

方法

利用 DMKG（德国头痛与偏头痛协会）头痛登记处的数据，采用患者整体印象变化（PGIC）作为锚点，运用平均变化和受试者工作特征曲线方法，确定 MIDAS 的最小重要差异（MID）。

结果

共纳入 1218 例成年偏头痛患者（85.6%为女性，40.2±12.8 岁，基线 MIDAS 为 44.2±47.4，随访 MIDAS 为 36.5±45.3）。对于基线 MIDAS＞20（MIDAS 分级 IV，n=757）的患者，使用 PGIC“稍有改善”作为锚点的不同方法得出 MIDAS 变化百分比 MID 为-29.4%至-33.2%。对于基线 MIDAS 为 6 至 20（分级 II 和 III，n=334）的患者，使用 PGIC“明显改善”作为锚点，差异变化 MID 为-3.5 至-4.5 分。