J Clin Neurol.  2019 Jan;15(1):90-96. 10.3988/jcn.2019.15.1.90.

Development and Validation of the Cluster Headache Screening Questionnaire

• Chung PW
• Cho SJ
• Kim BK
• Kim SK
• Lee MJ
• Choi YJ
• Park JW
• Kim BS
• Oh K
• Moon HS
• Song TJ
• Kang D
• Cho J
• Chung CS

• KMID: 2451150
• DOI: http://doi.org/10.3988/jcn.2019.15.1.90

Abstract

BACKGROUND AND PURPOSE
Cluster headache (CH) is frequently either not diagnosed or the diagnosis is delayed. We addressed this issue by developing the self-administered Cluster Headache Screening Questionnaire (CHSQ).
METHODS
Experts selected items from the diagnostic criteria of CH and the characteristics of migraine. The questionnaire was administered to first-visit headache patients at nine headache clinics. The finally developed CHSQ included items based on the differences in responses between CH and non-CH patients, and the accuracy and reliability of the scoring model were assessed.
RESULTS
Forty-two patients with CH, 207 migraineurs, 73 with tension-type headache, and 18 with primary stabbing headache were enrolled. The CHSQ item were scored as follows: 3 points for ipsilateral eye symptoms, agitation, and duration; 2 points for clustering patterns; and 1 point for the male sex, unilateral pain, disability, ipsilateral nasal symptoms, and frequency. The total score of the CHSQ ranged from 0 to 16. The mean score was higher in patients with CH than in non-CH patients (12.9 vs. 3.4, p < 0.001). At a cutoff score of >8 points, the CHSQ had a sensitivity, specificity, positive predictive value, and negative predictive value of 95.2%, 96%, 76.9%, and 99.3%, respectively.
CONCLUSIONS
The CHSQ is a reliable screening tool for the rapid identification of CH.

Keyword

cluster headache; diagnosis; migraine; prevalence; questionnaire; screening

MeSH Terms

Cluster Headache*
Diagnosis
Dihydroergotamine
Headache
Headache Disorders, Primary
Humans
Male
Mass Screening*
Migraine Disorders
Prevalence
Sensitivity and Specificity
Tension-Type Headache
Dihydroergotamine

Figure

• 

  Fig. 1 Distribution of the CHSQ scores between CH and non-CH patients. CH: cluster headache, CHSQ: Cluster Headache Screening Questionnaire.

• 

  Fig. 2 ROC curve for the diagnostic accuracy of the Cluster Headache Screening Questionnaire scoring system. Area under ROC curve=0.98. ROC: receiver operating characteristic.

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