• Knut Hagen, John-Anker Zwart, Anne Hege Aamodt, Kristian Bernhard Nilsen, Geir Bråthen, Grethe Helde, Marit Stjern, Erling A Tronvik, and Lars Jacob Stovner.
• Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway. knut.hagen@ntnu.no
• J Headache Pain. 2010 Feb 1;11(1):67-73.

AbstractThe Nord-Trøndelag Health Study (HUNT 3) performed in 2006-2008 is a replication of the cross-sectional survey from 1995 to 1997 (HUNT 2). The aim of the present study was to assess the sensitivity and specificity of questionnaire-based headache diagnoses using a personal interview by a neurologist as a gold standard. For the questionnaire-based status as headache sufferer, a sensitivity of 88%, a specificity of 86%, and a kappa statistic of 0.70 were found. Chronic headache, chronic tension-type headache (TTH), and medication overuse headache (MOH) were diagnosed with a specificity of > or =99%, and a kappa statistic of > or =0.73. Lower figures were found for the diagnoses of migraine and TTH. For individuals with headache > or =1 day per month, a sensitivity of 58% (migraine) and 96% (TTH), a specificity of 91 and 69%, and a kappa statistic of 0.54 and 0.44 were found, respectively. The specificity for migraine with aura was 95%. In conclusion, the HUNT 3-questionnaire is a valid tool for identifying headache sufferers, and diagnosing patients with chronic headache, including chronic TTH and MOH. The more moderate sensitivity for migraine and TTH makes the questionnaire-based diagnoses of migraine and TTH suboptimal for determining the prevalence. However, the high specificity of the questionnaire-based diagnosis of migraine, in particular for migraine with aura, makes the questionnaire a valid tool for diagnosing patients with migraine for genetic studies.

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