㈵-10 AF

㈵−１０	問診票，スクリーナーをどう使用するか

1) Cady RK, Borchert LD, Spalding W, Hart CC, Sheftell FD. Simple and 　 efficient recognition of migraine with 3-question headache screen. 　 Headache. 2004 Apr;44(4):323-7.
論文抄録	OBJECTIVE: To correlate the results of a new 3-question headache screen to 3 established methods of diagnosing migraine: the International Headache Society diagnostic criteria, physician's clinical impression, and presence of recurring disabling headaches. BACKGROUND: A simple tool to recognize patients who experience migraine may facilitate diagnosis of this debilitating and frequently undiagnosed condition. METHODS: Primary care physicians and neurologists in the United States enrolled 3014 adults with a diagnosis of migraine based on one of the following: International Headache Society criteria, an investigator's clinical impression, or presence of recurring disabling headaches. Each patient completed a 3-question headache screen: (1) Do you have recurrent headaches that interfere with work, family, or social functions? (2) Do your headaches last at least 4 hours? (3) Have you had new or different headaches in the past 6 months? A diagnosis of migraine was suggested by a yes answer to questions 1 and 2 and a no answer to question 3. RESULTS: The 3-question headache screen identified migraine in 77% of the study population; including 78% of the patients enrolled based on International Headache Society criteria, 74% based on clinical impression, and 68% because of recurring disabling headaches. CONCLUSIONS: Positive 3-question headache screen results agreed well with migraine diagnoses based on International Headache Society criteria, clinical impressions, and presence of recurring disabling headaches. These findings support use of the 3-question headache screen to recognize migraine.
文献 PubMed−ID	PMID: 15109356
エビデンスレベル	V
文献タイトル (日本語)	3項目頭痛質問票を用いた簡便で有効な片頭痛の認知
目的	頭痛のスクリーニングで用いることが出来る簡単な質問の項目を決定すること
研究施設	米国の多施設の診療所
対象患者	18 − 72 歳の片頭痛患者 3400 人
介入	3つの項目からなる質問票に返答する．㈰支障度の高い反復性の頭痛があるか，㈪4時間以上持続する頭痛か，㈫過去6ヶ月間に新たなあるいは，異なった頭痛が存在したか．㈰㈪に「はい」㈫に「いいえ」と答えた場合，片頭痛と診断される．
結果	3項目の質問票を用いて77％が片頭痛と診断された．IHSの診断基準78％，臨床的印象で74％，反復性の頭痛から68％が片頭痛と診断された．
結論	3項目の質問からなる片頭痛スクリーニングからの診断はIHSの診断基準，臨床的印象，反復性の支障を来たす頭痛のそれぞれをもとに片頭痛と診断したときとほぼ一致していた．片頭痛の理解のために3項目の質問票を用いることは有用である．
備考	MeSH Terms: • Adult • Female • Humans • Male • Mass Screening • Migraine/diagnosis* • Office Visits • Questionnaires* • Recurrence • Research Support, Non-U.S. Gov't ・ Sensitivity and Specificity
作成者	飯ｹ谷美峰

2) Lipton RB, Dodick D, Sadovsky R, Kolodner K, Endicott J, Hettiarachchi 　 J, Harrison W;A self-administered screener for migraine in primary care: 　 The ID Migraine validation study.Neurology. 2003 Aug 12;61(3):375-82.
論文抄録	BACKGROUND: Migraine is a highly prevalent and disabling illness that remains substantially undiagnosed in primary care. Because of the potential value of a screening tool, the current study was designed to establish the validity and reliability of a brief, self-administered migraine screener in patients with headache complaints in the primary care setting. METHODS: A total of 563 patients presenting for routine primary care appointments and reporting headaches in the past 3 months completed a self-administered migraine screener. All patients were then referred for an independent diagnostic evaluation by a headache expert, of whom 451 (80%) completed a full evaluation. Migraine diagnosis was assigned based on International Headache Society criteria after completing a semi-structured diagnostic interview. RESULTS: Of nine diagnostic screening questions, a three-item subset of disability, nausea, and sensitivity to light provided optimum performance, with a sensitivity of 0.81 (95% CI, 0.77 to 0.85), a specificity of 0.75 (95% CI, 0.64 to 0.84), and positive predictive value of 0.93 (95% CI, 89.9 to 95.8). Test-retest reliability was good, with a kappa of 0.68 (95% CI, 0.54 to 0.82). The sensitivity and specificity of the three-item migraine screener was similar regardless of sex, age, presence of other comorbid headaches, or previous diagnostic status. CONCLUSIONS: The three-item ID Migraine migraine screener was found to be a valid and reliable screening instrument for migraine headaches. Its ease of use and operating characteristics suggest that it could significantly improve migraine recognition in primary care.
文献 PubMed−ID	PMID: 12913201 [PubMed - indexed for MEDLINE]
エビデンスレベル	V
文献タイトル (日本語)	プライマリケアにおける片頭痛の自己管理型スクリーニング票： ID Migraine TM の正当化研究
目的	患者の自己報告を用いた簡潔なスクリーニングツールの有効性と信頼性を確立すること
研究デザイン	Multicenter Study, Validity study
研究施設	米国の一般診療所 27箇所と頭痛専門外来12箇所
研究期間	2000年4月から2000年8月までに患者を登録
対象患者	18歳から55歳の男女563名・英語の読み書き能力を有すること・過去のファイザー製薬主催の片頭痛調査に未参加であること・過去 3ヶ月間に2回以上の頭痛発作がある・過去に片頭痛という診断をされていない
介入	定時の予約で来院した患者で，過去 3ヶ月間に頭痛があったと報告した563名のに自己記入式の片頭痛スクリーニング票を作成させた．すべての患者は頭痛専門家独自の診断的評価を受けており，451名（80％）の患者は全評価を完了した．
主要評価項目とそれに用いた統計学的手法	各質問項目に対しての感度，特異度，陽性的中率を算出．
結果	スクリーニングのための 9つの質問のうち，支障度，吐気，光過敏についての3項目が最も良好な成果が得られた．感度0.81(95% CI, 0.77 to 0.85)，特性0.75 (95% CI, 0.64 to 0.84), 陽性的中率0.93 (95% CI, 89.9 to 95.8)．テスト-再テスト信頼度はκ0.68 (95% CI, 0.54 to 0.82)で良好だった．3項目の片頭痛スクリーニング票の感度と特性は性別，年齢，他の頭痛の合併の有無を問わず良好だった．
結論	支障度，悪心，光過敏の 3項目は片頭痛の診断にとって有用なスクリーナーとなる．プライマリケアでの頭痛のスクリーニング手段として開発されたID migraine の高い信頼性が確認された．
備考	Publication Types: Multicenter Study Validation Studies MeSH Terms: • Adolescent • Adult • Female • Human • Interviews • Likelihood Functions • Logistic Models • Male • Mass Screening/methods* • Mass Screening/standards • Middle Aged • Migraine/diagnosis* • Patient Participation/methods* • Predictive Value of Tests • Primary Health Care/methods* • Quality of Life • Questionnaires/standards* • Referral and Consultation/statistics & numerical data • Sensitivity and Specificity • Support, Non-U.S. Gov't • United States
作成者	飯ヶ谷美峰

3) Stewart WF, Lipton RB, Kolodner K, Liberman J, Sawyer J. Reliability of 　 the migraine disability assessment score in a population-based sample 　 of headache sufferers. Cephalalgia. 1999 Mar;19(2):107-14; discussion 　 74.
論文抄録	BACKGROUND: The Migraine Disability Assessment (MIDAS) score is used to quantify headache-related disability. In a previous study, we showed that the MIDAS score was highly reliable in population-based samples of migraine headache sufferers in two countries. OBJECTIVES: To examine the test-retest reliability and internal consistency of the five items comprising the MIDAS score and the overall MIDAS score in a population-based sample of both migraine and nonmigraine headache sufferers. METHODS: Using a clinically validated telephone interview, a population-based sample of migraine and nonmigraine headache sufferers was identified in Baltimore , Maryland , USA . A total of 97 migraine cases and 80 nonmigraine subjects completed the MIDAS questionnaire on two occasions an average of 3 weeks apart. The MIDAS score is derived from five questions about missed time from work (or school) and household work (one question each about missed days and days with at least 50% reduced productivity) and missed days of nonwork activities. RESULTS: Among all headache sufferers the test-retest Spearman's correlations of individual MIDAS questions ranged from 0.67 to 0.73. The Spearman's correlation for the MIDAS score (i.e., sum of lost days and reduced effectiveness days in each domain) was 0.84. Cronbach's alpha, a measure of internal consistency, was 0.83. Mean and median item values and the overall MIDAS scores differed between migraine and nonmigraine cases. Even after adjusting for differences in headache frequency, the mean MIDAS scores differed substantially (i.e., 10.3 points) between migraine cases and nonmigraine cases. CONCLUSIONS: The reliability and internal consistency of the MIDAS score are high, as tested in a population-based sample of headache sufferers. MIDAS scores are substantially higher in migraine cases than in non-migraine cases, supporting the validity of the measure.
文献 PubMed−ID	PMID: 10214536
エビデンスレベル	㈽
文献タイトル (日本語)	人口ベース標本の有頭痛者における片頭痛支障度評価スコアの信頼性
目的	5項目からなるMIDASスコアとMIDAS総スコアのテスト再テスト信頼性と内的整合性を人口ベースにおいて片頭痛患者と非片頭痛者で調査すること
研究施設	メリーランド州ボルチモア
研究期間	記載なし
対象患者	メリーランド州ボルチモアの住人
介入	メリーランド州ボルチモアの住人に電話インタビュー（ clinically validated computer-assisted telephone interview ;CATI）を行い対象者を集め，同意を得た後に信頼性調査に参加させた．対象者は3週間の前後で2回のMIDAS質問票を記入．
主要評価項目とそれに用いた統計学的手法	テスト再テストにおける各々の質問項目を Spearmanの相関係数で解析．内的整合性に関してはCronbachαを使用した．
結果	MIDAS質問票の各項目におけるSpearmanの相関係数は0.67から0.73だった．MIDASスコアのためのSpearman相関係数は0.84だった．Cronbachαで示される内的整合性は0.83．MIDASの総スコアの平均値と中央値は片頭痛患者と非頭痛者では差異があり，頭痛頻度を調整しても平均値は異なった．
結論	人口ベースサンプルの頭痛患者で試験されたように MIDASスコアの信頼性と内的整合性は高い．MIDASスコアは計測の妥当性を支持するように実質的に非頭痛者より片頭痛患者で高かった．
備考	MeSH Terms: • Adolescent • Adult • Disability Evaluation* • Female • Human • Male • Middle Aged • Migraine/physiopathology* • Pain Measurement • Questionnaires • Support, Non-U.S. Gov't
作成者	飯ｹ谷美峰

4) Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN. 　 Validity of the Migraine Disability Assessment (MIDAS) score in 　 comparison to a diary-based measure in a population sample of 　 migraine sufferers. Pain. 2000 Oct;88(1):41-52.
論文抄録	The Migraine Disability Assessment (MIDAS) questionnaire is a brief, self-administered questionnaire designed to quantify headache-related disability over a 3 month period. The MIDAS score has been shown to have moderately high test-retest reliability in headache sufferers and is correlated with clinical judgment regarding the need for medical care. The aim of the study was to examine the validity of the MIDAS score, and the five items comprising the score, compared to data from a 90 day daily diary used, in part, to record acute disability from headache. In a population-based sample, 144 clinically diagnosed migraine headache sufferers were enrolled in a 90 day diary study and completed the MIDAS questionnaire at the end of the study. The daily diary was used to record detailed information on headache features as well as activity limitations in work, household chores, and non-work activities (social, family and leisure activities). The MIDAS score was the sum of missed work or school days, missed household chores days, missed non-work activity days, and days at work or school plus days of household chores where productivity was reduced by half or more in the last 3 months. Validity was assessed by comparing MIDAS items and the MIDAS score with equivalent measures derived from the diary. The MIDAS items for missed days of work or school (mean 0.96, median 0) and for missed days of household work (mean 3.64, median 2.0) were similar to the corresponding diary-based estimates of missed work or school (mean 1.23, median 0) and of missed household work (mean 3.93, median 2.01). Values for missed days of non-work activities (MIDAS mean 2.6 and median 1 versus diary mean 2.22 and median 0.95) were also similar. Responses to MIDAS questions about number of days where productivity was reduced by half or more in work (mean 3.77, median 2.00) and in household work (mean 3.92, median 2.00) significantly overestimated the corresponding diary-based measures for work (mean 2.94, median 1.06) and household work (mean 2.22, median 0.98). Nonetheless, the overall MIDAS score (mean 14.53, median 9.0) was not significantly different form the reference diary-based measure (mean 13.5, median 8.4). The correlation between the MIDAS summary score and an equivalent diary score was 0.63. The group estimate of the MIDAS score was found to be a valid estimate of a rigorous diary-based measure of disability. The mean and median values for the MIDAS score in a population-based sample of migraine cases were similar to equivalent diary measures. The correlation between the two measures was in the low moderate range, but expected given that two very different methods of data collection were compared.
文献 PubMed−ID	PMID: 11098098
エビデンスレベル	㈽
文献タイトル (日本語)	片頭痛もちの人口標本における MIDASスコアの妥当性
目的	MIDASスコアの妥当性を評価するため、MIDASの5項目の質問のスコアおよび合計スコアと90日間の頭痛日記から得られるデータを比較検討する．
研究デザイン	Validation studies
研究施設	記載なし
研究期間	3 November 1997 and 10 December 1997 .
対象患者	メリーランド州ボルチモアの電話インタビューを受けた片頭痛もち 884 名のうちランダムに選ばれた 426 名
介入	メリーランド州ボルチモアの住人に電話インタビュー（ clinically validated computer-assisted telephone interview ;CATI）を行い対象者を集め，同意を得た後に妥当性調査に参加させた．対象者は90日間の頭痛日記を記入後MIDAS質問票を記入する．
主要評価項目とそれに用いた統計学的手法	MIDASの質問項目とスコアの妥当性を検討するため90日間の日記から得られるデータの平均値，中央値を算出
結果	仕事及び学校を休んだ日数およｂひ家事不能だった日数および仕事以外の活動が不能だった日数日記から得られた値と類似していた．仕事と家事の生産性が半減舌日数は MIDASスコアが日記スコアより過大評価されていた．全体のMIDASスコアは日記スコアと大きな差異は認められなかった．MIDASの合計スコアと日記から得られた合計スコアの相関は0.63だった．
結論	MIDASスコアで見積もられたグループは日記に基づいた支障度の計測値の見積もりと妥当であることが示された．人口ベース標本におけるMIDASスコアの平均値，中央値は日記の計測値と類似していた．
コメント	研究およびレポートの質は高い．
備考	Publication Types:　Validation studies MeSH Terms: • Absenteeism • Adult • Comparative Study • Disability Evaluation* • Efficiency • Female • Human • Male • Medical Records* • Middle Aged • Migraine/physiopathology* • Questionnaires • Support, Non-U.S. Gov't
作成者	飯ｹ谷美峰

5) Iigaya M, Sakai F, Kolodner KB, Lipton RB, Stewart WF. Reliability and 　 validity of the Japanese Migraine Disability Assessment (MIDAS) 　 Questionnaire. Headache. 2003 Apr;43(4):343-52.
論文抄録	OBJECTIVE: This study was designed to assess the test-retest reliability, internal consistency, and validity of a Japanese translation of the Migraine Disability Assessment (MIDAS) Questionnaire in a sample of Japanese patients with headache. BACKGROUND: Previous studies have demonstrated that the English-language version of the MIDAS Questionnaire is a reliable and valid instrument for the assessment of migraine-related disability. Any translations of the MIDAS Questionnaire must also be assessed for reliability and validity. METHODS: Study participants were recruited from the patient population attending either the Neurology Department of Kitasato University or an affiliated clinic. Participants were eligible for study entry if they had 6 or more primary headaches per year. For reliability testing, participants completed the MIDAS Questionnaire on 2 occasions, exactly 2 weeks apart. To assess validity, patients were also invited to participate in a 90-day daily diary study. Composite measures from the 90-day diaries were compared to equivalent MIDAS measures (ie, 5 questions on headache-related disability and 1 question each on average pain intensity and headache frequency in the last 3 months) and to the total MIDAS score obtained from a third MIDAS Questionnaire completed at the end of this 90-day period. RESULTS: One hundred one patients between the ages of 21 and 77 years were recruited (81 women and 20 men). Ninety-nine patients (80 women and 19 men) participated in the diary study. At baseline, 46.5% of patients were MIDAS grade I or II (minimal, mild, or infrequent disability), 22.2% were MIDAS grade III (moderate disability), and 31.3% were MIDAS grade IV (severe disability). Test-retest Spearman correlations for the 5 disability questions and the questions on average pain intensity and headache frequency ranged from 0.59 to 0.80 (P<.0001). The test-retest Spearman correlation coefficient for the total MIDAS score was 0.83 (P<.0001). The degree to which individual MIDAS questions correlated with the diary-based measures ranged from 0.36 to 0.88. The correlation between the total MIDAS score and the equivalent diary-based measure was 0.66. In general, the mean and median values for the MIDAS items and total MIDAS score were similar to the means and medians for the diary-based measures. However, the mean MIDAS scores for the number of days on which headache was experienced and the number of missed workdays were significantly different compared to the diary-based estimates for these items (P<.05). In addition, the mean MIDAS score for the number of days of missed housework was significantly higher than the corresponding diary-based estimate (P<.01). CONCLUSIONS: The results from this study show that the Japanese translation of the MIDAS Questionnaire is comparable with the English-language version in terms of reliability and validity.
文献 PubMed−ID	PMID: 12656705 [PubMed - indexed for MEDLINE
エビデンスレベル	Ib
文献タイトル (日本語)	MIDAS質問票日本語版の信頼性及び妥当性
目的	米国で開発された MIDAS質問票の日本語版を作成し，その有効性と信頼性を確立すること
研究デザイン	Validity study
研究施設	北里大学病院神経内科外来
研究期間	2000年7月から2000年11月までに患者を登録
対象患者	年間 6回以上の1次性頭痛を有する患者．
介入	信頼性テスト：患者に 2週間隔でMIDAS質問票を2回記入してもらう．妥当性テスト： 3ヶ月間毎日頭痛の日記を記載してもらう．日記の作成が終了する90日目患者はに再びMIDAS質問票を記入する．これより日記から算出したMIDASスコアと90日後のMIDAS質問票から得られたスコアを比較検討する．
結果	信頼性テスト；患者は 21歳から77歳までの101名(男性22名，女性81名　妥当性テスト：そのうち99人が日記調査に参加した．重症度分類ではグレード1および2は46.5％，グレード3は22.2％，グレード4は31.3％．テスト-再テスト試験における頭痛強度のスピアマン相関係数は0.59〜0.80（P<0.0001），MIDASスコアのスピアマン相関係数は0.83（P<0.0001）だった．個々の質問項目に関して係数は0.36-0.88の幅があった．妥当性テストにおいて日記とMIDASの総スコアの相関は0.66であった．
結論	本研究により MIDAS質問票日本語版の信頼性と妥当性が示された．
備考	Publication Types: Validation Studies MeSH Terms: Adult Aged Disability Evaluation* Female Human Japan Language Male Middle Aged Migraine/classification Migraine/complications* Questionnaires/standards* Reproducibility of Results Translations Work
作成者	飯ヶ谷美峰

6) Hershey AD, Powers SW, Vockell AL, LeCates S, Kabbouche MA, 　 Maynard MK.PedMIDAS: development of a questionnaire to assess 　 disability of migraines in children. Neurology. 2001 Dec 11;57(11): 　 2034-9.
論文抄録	BACKGROUND: For adults, disability produced by migraines has been assessed with a migraine-specific disability tool-MIDAS. The objective of this study was to develop and validate a similar tool that accurately depicts the disability of headaches in school-age children and adolescents. METHODS: A six-question tool (PedMIDAS) was developed and administered to patients attending a tertiary referral center for pediatric headaches. Internal consistency and test/retest reliability were assessed. Validity was assessed by correlating scores with headache frequency, severity, and duration. Changes in the total score in response to treatment were assessed in a portion of the patients. RESULTS: The PedMIDAS questionnaire was administered to 441 patients for a total of 724 trials. The mean score at the initial visit was 44.3 +/- 47.9, whereas the overall mean score was 25.1 +/- 36.5. A 2-week test/retest reliability assessment for 56 patients confirmed the stability of the instrument with a Pearson coefficient of 0.80. The correlation of the PedMIDAS score with frequency, severity, and duration had Pearson's coefficient values of 0.58, 0.27, and 0.23. The PedMIDAS score was reduced to 20.0 +/- 32.3 (p < 0.0001) at the first follow-up assessment with subsequent continued reduction. CONCLUSIONS: The PedMIDAS questionnaire provided a developmentally sensitive, reliable, and valid assessment of the disability of childhood and adolescent headaches. This questionnaire provides a tool to assess the impact of migraines in children and to monitor response to treatment. Further research should focus on additional validation of the PedMIDAS using a larger population and sampling from other populations (e.g., primary care and community samples).
文献 PubMed−ID	PMID: 11739822
エビデンスレベル	㈽
文献タイトル (日本語)	PedMIDAS:小児における片頭痛の支障度評価のための質問票の展開
目的	学童期の小児と思春期の若者における頭痛の支障を正確に表すツールを開発する
研究デザイン	open, prospective, multinational, observational, two-visit study,
研究施設	頭痛センターあるいはシンシナティ子供病院メディカルセンターのサテライト施設
研究期間	記載なし
対象患者	片頭痛と臨床診断された小児 441名
主要評価項目とそれに用いた統計学的手法	正常化分布を用いたｚスコアと pスコアを応用した平均値と標準偏差を統計解析に使用．試行と観察の連続の比較にPearson相関係数を使用．
結果	合計 724のトライアルのため441人の患者にPedMIDAS質問票が施された．56名の患者で行ったテスト再テスト信頼性調査はPearson相関係数で0.80でツールとしての安定性が示された．頻度，重症度，期間によるPedMIDASスコアのPearson係数はそれぞれ0.58,0.27,0.23だった．
結論	PedMIDAS質問票はは小児期と思春期の子供の頭痛による支障度を評価するのに感度，信頼性，妥当性が高い．質問票は小児における頭痛の影響を評価したり，治療の反応性をモニターしたりするツールとなる．
備考	MeSH Terms: • Adolescent • Child • Child, Preschool • Cohort Studies • Disability Evaluation* • Female • Human • Male • Migraine/diagnosis* • Psychometrics • Quality of Life • Reproducibility of Results • Sickness Impact Profile*
作成者	飯ｹ谷美峰

7) Bayliss MS, Dewey JE, Dunlap I, Batenhorst AS, Cady R, Diamond ML, 　 Sheftell F. A study of the feasibility of Internet administration of a 　 computerized health survey: the headache impact test (HIT). Qual Life 　 Res. 2003 Dec;12(8):953-61
論文抄録	BACKGROUND: Headache impact test (HIT) is a precise, practical tool that quantifies the impact of headache on respondents' lives. It is the first widely-available dynamic health assessment (DynHA). Applications of this brief, precise survey include population based screening for disabling headaches, tracking of individual patient scores over time, disease management programs and others. We use data from Internet HIT assessments during the fall of 2000 to (1) evaluate characteristics of respondents and assessments, (2) assess the utility of joint administration of HIT and the SF-8 Health Survey (SF-8) to screen for migraine and depression, and (3) explore associations between HIT scores and subsequent healthcare-related attitudes and behaviors. METHODS: We analyzed Internet HIT surveys completed between 9/1 and 11/30/2000 (n = 19,195). Subsamples include respondents who also completed (1) a 12-item Internet survey assessing severity, frequency, cause and management of headaches; (2) an e-mail survey measuring healthcare-related behaviors; (3) the SF-8; or (4) the website registration process, providing age and gender data. We used analysis of variance (ANOVA) to evaluate HIT score differences associated with age, gender, headache severity or frequency, and healthcare-related behaviors and attitudes and chi2 tests to assess the prevalence and comorbidity of migraine and depression. RESULTS: Three-quarters of respondents achieved a precise HIT score in < or = 5 items. Most had moderate/severe headaches; 65% had headaches at least monthly. HIT scores were directly related to headache severity and frequency. Most respondents were females, with significantly higher HIT scores than males. Most HIT respondents were between ages 25 and 54 (HIT scores were higher for younger respondents). Sixty four percent screened positive for migraine; 20% for depression. Both conditions were more prevalent among females than males. Comorbid migraine and depression was 50% more prevalent among females and increased with age until age 50. Patients with worse headache impact were more likely to seek care, discuss headaches with their providers and find HIT useful. CONCLUSIONS: It is feasible to use Internet-based dynamic assessments to measure health status. These data complement previous results showing that HIT differentiates respondents according to headache characteristics (severity and frequency). HIT plus SF-8 yields a practical screen for migraine and depression in headache patients and may lead to more effective treatment for patients with these conditions. Preliminary findings suggest that the experience of taking HIT on the Internet may motivate headache patients to seek care and discuss headaches with their providers.
文献 PubMed−ID	PMID: 14651414
エビデンスレベル	㈽
文献タイトル (日本語)	インターネットで行なうコンピュータ化された健康調査の実用性についての研究； Headahce Impact Test(HIT)
目的	インターネット HITからのデータをもとに㈰回答者とそのHIT内容の特徴を評価する．㈪片頭痛とうつのスクリーニングとしてHITとSF-8の連結評価の有用性を検討する．㈫HITスコアと体調に基づく行動の関連性を検討する．
研究デザイン	Internet survey
研究施設	不明
研究期間	2000年9月1日〜11月30日
介入	19195名に電話調査を行った． Internet Study;12項目の重度，頻度，原因，頭痛管理，を評価 Email Survey：ヘルスケア関連の行動の測定（SF8） Analysis of Variance(ANOVA)
主要評価項目とそれに用いた統計学的手法	年齢・性別・頭痛の重度と頻度，ヘルスケア関連行動に関連した HITスコアの違いを評価． Chi2 test：片頭痛とうつの有病率とcomorbidityを評価する．
結果	中等度から十度の片頭痛はほとんどの症例． 65％は少なくとも連日の頭痛を有していた．
結論	健康状態を計測するためインターネットベースの評価法と HITは実用可能である．
備考１	MeSH Terms: • Adolescent • Adult • Aged • Computer Systems • Feasibility Studies • Female • Headache/physiopathology* • Humans • Internet* • Male • Middle Aged • Psychometrics • Quality of Life • Questionnaires* • Sickness Impact Profile*
備考２	HITへのアクセス www.amIhealthy.com , www.headachetest.com ,
作成者	飯ｹ谷美峰

8) Kosinski M, Bayliss MS, Bjorner JB, Ware JE Jr, Garber WH, Batenhorst 　 A, Cady R, Dahlof CG, Dowson A, Tepper S. A six-item short-form 　 survey for measuring headache impact: the HIT-6. Qual Life Res. 2003 　 Dec;12(8):963-74.
論文抄録	BACKGROUND: Migraine and other severe headaches can cause suffering and reduce functioning and productivity. Patients are the best source of information about such impact. OBJECTIVE: To develop a new short form (HIT-6) for assessing the impact of headaches that has broad content coverage but is brief as well as reliable and valid enough to use in screening and monitoring patients in clinical research and practice. METHODS: HIT-6 items were selected from an existing item pool of 54 items and from 35 items suggested by clinicians. Items were selected and modified based on content validity, item response theory (IRT) information functions, item internal consistency, distributions of scores, clinical validity, and linguistic analyses. The HIT-6 was evaluated in an Internet-based survey of headache sufferers (n = 1103) who were members of America Online (AOL). After 14 days, 540 participated in a follow-up survey. RESULTS: HIT-6 covers six content categories represented in widely used surveys of headache impact. Internal consistency, alternate forms, and test-retest reliability estimates of HIT-6 were 0.89, 0.90, and 0.80, respectively. Individual patient score confidence intervals (95%) of app. +/-5 were observed for 88% of all respondents. In tests of validity in discriminating across diagnostic and headache severity groups, relative validity (RV) coefficients of 0.82 and 1.00 were observed for HIT-6, in comparison with the Total Score. Patient-level classifications based in HIT-6 were accurate 88.7% of the time at the recommended cut-off score for a probability of migraine diagnosis. HIT-6 was responsive to self-reported changes in headache impact. CONCLUSIONS: The IRT model estimated for a 'pool' of items from widely used measures of headache impact was useful in constructing an efficient, reliable, and valid 'static' short form (HIT-6) for use in screening and monitoring patient outcomes.
文献 PubMed−ID	PMID: 14651415
エビデンスレベル	㈽
文献タイトル (日本語)	頭痛のインパクトを計測するための 6項目のショートフォーム調査：HIT-6
目的	臨床研究や診療において患者のスクリーニングやモニタリングに使用しうる信頼性，妥当性を有する簡潔で幅広い内容を持った頭痛インパクトを評価する HIT-6の開発をする．
介入	HIT-6能項目は既存の54項目と臨床かによって提案された35項目から選択された．選択項目は妥当性，項目反応セオリー（IRT）情報機能，内的整合性，スコアの配分，言語的分析に基づいて修正された．HIT-6はアメリカオンライン（AOL）のメンバーからなる1103名の頭痛患者のインターネット調査で評価された．14日後の540名に対して追跡調査を行なった．
結果	HIT-6の内的整合性；0.89，交替配列型0.90，試験再試験信頼度0.80であった．
結論	頭痛のインパクトを計測するために広く用いられている項目を見積もる IRTモデルは，患者の成果をスクリーニングしたりモニタリングするための，有効で信頼性と妥当性を有するショートフォーム（HIT-6）を構築するのに有用であった．
備考	MeSH Terms: • Adult • Calibration • Headache/physiopathology* • Humans • Internet* • Psychometrics • Quality of Life • Questionnaires* • Sickness Impact Profile* • United States
作成者	飯ｹ谷美峰

10) Wagner TH, Patrick DL, Galer BS, Berzon RA. A new instrument to 　 assess the long-term quality of life effects from migraine: development 　 and psychometric testing of the MSQOL.Headache. 　 1996 Sep;36(8):484-9
論文抄録	Quality of life is important to persons experiencing migraine. This study discusses the development of a migraine-specific quality-of-life measure (MSQOL). Participants, who included migraineurs from both tertiary care centers and the community, were screened using the International Headache Society migraine criteria prior to enrollment. Internal consistency of the MSQOL was high (alpha 0.92). Reproducibility over an average of 24 days was high (intraclass correlation 0.90). Construct validity was determined by convergent validity and known groups validity. The MSQOL was compared to two other frequently used health status questionnaires; results indicate that the MSQOL more closely resembles well-being than functional status. Results also indicate that migraineurs with more symptoms, medical appointments per year to treat migraines, and migraine episodes per year have a significantly worse quality of life. The MSQOL proved valid and reliable as a self-administered measure and will be a useful tool in clinical migraine research. The information gained from its use in the clinical environment should provide important additional information about the impact of migraine on quality of life and the potential benefits of therapeutic interventions.
文献 PubMed−ID	PMID: 8824004
エビデンスレベル	㈽
文献タイトル (日本語)	片頭痛から影響を受ける長期的 QOLを評価するための新しい道具；MSQOLの開発と心理測定的テスト
目的	片頭痛患者にとっての QOL測定法の開発について検討する．
対象患者	シアトル地域の住民を対象に公共掲示板や広告を用いて参加者を募集，そのうちの 175人の片頭痛患者を選定．
介入	1.片頭痛に特異的な質問群の開発， 2.質問票試案の構成と改良， 3.MSQOLの心理測定的テストを行なった．
主要評価項目とそれに用いた統計学的手法	内的整合性評価（ Cronbach α），再現性調査（クラス内相関係数）
結果	MSQOLの内的整合性は高かった（Cronbach α0.92）平均24日の再現性はクラス内相互関係0.90で高かった．MSQOLと他のの2種類の健康状態アンケートを比較したところ， MSQOL が機能状態よりも，幸福の状態 (well-being) により近似していることがわかった．
結論	長期の治療転帰を評価するとき， MSQOLには片頭痛患者の生活の質に関する有益な情報を提供して，役立つ補助計測である可能性がある．
備考	MeSH Terms: • Adult • Comparative Study • Female • Health Status Indicators* • Humans • Male • Migraine/complications • Migraine/physiopathology • Migraine/psychology • Psychometrics • Quality of Life • Questionnaires/standards • Reproducibility of Results • Research Support, Non-U.S. Gov't
作成者	飯ｹ谷美峰

11) Martin BC, Pathak DS, Sharfman MI, Adelman JU, Taylor F, Kwong 　　WJ, Jhingran P. Validity and reliability of the migraine-specific quality 　　 of life questionnaire (MSQ Version 2.1). Headache. 2000 　　　Mar;40(3):204-15.
論文抄録	OBJECTIVE: To assess the scaling properties, reliability, and validity of the revised Migraine-Specific Quality of Life Questionnaire (MSQ) (Version 2.1) BACKGROUND: The MSQ is a disease-specific, quality-of-life instrument with three hypothesized scales that has been developed, tested, and revised. METHODS: The study used a multicenter, nondrug, prospective, parallel group, quasi-experimental design. Patients with migraine were recruited at outpatient headache specialty practices and were administered the MSQ, the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and migraine symptom questionnaires at baseline, 4 weeks, and 12 weeks. Internal consistency (Cronbach alpha) and 4-week test-retest reproducibility (intraclass correlation coefficients) were estimated to assess reliability. Construct validity was assessed using an adaptation of the Campbell and Fiske multitrait-multimethod approach and by correlating MSQ scores with symptom measures. RESULTS: A total of 267 subjects enrolled in the trial. The criteria for summated rating scales were all met. The internal consistency coefficients ranged from 0.86 to 0.96, and the intraclass correlation coefficients ranged from 0.57 to 0.63 across the three dimensions. As anticipated, the MSQ dimensions had low-to-modest correlations with the two component scores of the SF-36 and were modestly to moderately correlated with migraine symptoms. CONCLUSIONS: The MSQ is a reliable instrument in the assessment of quality of life for patients with migraine with items that can be summed without weights. The MSQ has demonstrated evidence of construct validity.
文献 PubMed−ID	PMID: 10759923
エビデンスレベル	㈽
文献タイトル (日本語)	片頭痛に特異的な QOL質問票（MSQ2.1）の妥当性と信頼性
文献タイトル（英語）	Validity and reliability of the migraine-specific quality of life questionnaire (MSQ Version 2.1).
著者名	Martin BC, Pathak DS, Sharfman MI, Adelman JU, Taylor F, Kwong WJ, Jhingran P.
雑誌名 ,出版年巻: 頁	Headache. 2000 Mar;40(3):204-15.
目的	改定版 MSQの計測特性と信頼性，妥当性を評価する．
研究デザイン	Multicenter Study
研究施設	多施設
対象患者	複数の頭痛専門外来における未治療の片頭痛患者を対象とした．
介入	片頭痛患者に治療の前， 4週間後，12週間後の医療的結果をMSQおよびSF-36を用いて評価した．
主要評価項目とそれに用いた統計学的手法	信頼性評価；内的整合性（ Cronbach α）と試験再試験再現性（クラス内相関係数）妥当性評価； CampbellとFiskeのmustitrait-multimethodアプローチ適合を用いて評価
結果	267人がトライアルに登録された．内的整合性係数は 0.86〜0.96，クラス内相関係数は0.57〜0.65だった．
結論	MSQver2.1は片頭痛患者のQOLを評価するために高い信頼性を有する道具である．MSQの構造的妥当性の証拠が示された．
備考	MeSH Terms: • Evaluation Studies • Humans • Migraine/physiopathology* • Prospective Studies • Quality of Life* • Questionnaires/standards* • Reproducibility of Results • Research Support, Non-U.S. Gov't
作成者	飯ｹ谷美峰

12) Chatterton ML, Lofland JH, Shechter A, Curtice WS, Hu XH, Lenow J,
　 Smullens SN, Nash DB, Silberstein SD. py assessment
　 questionReliability and validity of the migraine theranaire. Headache.
　 2002 Nov-Dec;42(10):1006-15.

論文抄録

OBJECTIVE: To determine the reliability and validity of the Migraine Therapy Assessment Questionnaire (MTAQ). DESIGN/METHODS: Eligible patients between ages 18 and 65 with at least one migraine per month, a physician visit in the preceding 6 months, and a migraine diagnosis were recruited from physician offices in the Philadelphia area. Participants completed the MTAQ, Short Form-36 (SF-36), the Migraine Disability Assessment Score (MIDAS), the Beck Depression Inventory, a demographic questionnaire, and a medication use survey. The first 100 participants completed a second MTAQ approximately 2 weeks later. The test-retest reliability, construct, and predictive validity of the MTAQ were assessed. RESULTS: Two hundred fifty-one patients were recruited; 243 patients were assessable. All MTAQ questions had a kappa statistic of.5 or higher and an agreement of at least 76%. There was a significant level of agreement (.71) for the MTAQ summary score. MTAQ items regarding control, frequency, work loss, resource use, and satisfaction were associated with significant differences in SF-36 scores. MTAQ items related to work loss, emergency department use, headache frequency, and control were associated with days missed from work and degree of disability as measured by MIDAS. Suboptimal migraine management was significantly associated with MTAQ items indicating three or more headaches per month, missing time from work or school, taking daily medication for headaches, and having an emergency department visit in the last 6 months. CONCLUSION: MTAQ is a reliable and valid questionnaire to identify migraineurs whose migraine management may be suboptimal in a primary care setting.

文献 PubMed−ID

PMID: 12453032

エビデンスレベル

㈽

文献タイトル (日本語)

片頭痛治療評価質問票（ MTAQ）の信頼性と妥当性

目的

片頭痛治療評価質問票の信頼性と有効性を決定する．

研究デザイン

Cross-sectional study

研究施設

フィラデルフィアの診療所

研究期間

記載なし

対象患者

1ヶ月に1回以上の片頭痛を有し，6ヶ月以上の通院歴がある患者

介入

対象患者には， MTAQ，SF-36，MIDAS，Beck抑うつ質問票，人口統計質問票，使用薬物調査を記入させる．

主要評価項目とそれに用いた統計学的手法

Statistical Analysis Software（version6.12, SAS,Cary, NC,USA）を使用．
テスト再テスト信頼性調査； Cohen's kappaとPearson's/Kendall　sutatistics
妥当性調査： Student's T testを使用．

結果

251名の患者のうち243人が評価対象となった．
MTAQの質問項目はカッパ統計で.5以上を有し少なくとも76％以上の一致を認めた．制御，頻度，仕事の損失，救急外来の受診，そして満足度はSF-36のスコアと有意な差が認められた．仕事上の損失，救急外来の利用，頭痛頻度，とコントロールに関連したMTAQの項目は仕事を休んだ日数およびMIDASで計測された支障度の程度と関連があった．不十分な頭痛管理は月3回以上の頭痛，仕事や学校の損失時間，頭痛のための毎日の治療，6ヶ月以内の救急外来受診と関連していた．

結論

MTAQがプライマリケアでの管理が困難な片頭痛患者を同定する質問票であることの信頼性，妥当性が確立された．

備考１

MeSH Terms:
• Adolescent
• Adult
• Cross-Sectional Studies
• Human
• Male
• Middle Aged
• Migraine/therapy*
• Philadelphia
• Questionnaires/standards*
• Reproducibility of Results
• Support, Non-U.S. Gov't

備考 2

YES	NO
		片頭痛薬を飲んだあと，たいてい 2時間以内に片頭痛症状は軽くなる．
		片頭痛薬を飲んだあと，たいてい 2時間以内にもとの活動に戻ることが出来る．
		ほとんど毎月， 3回以上片頭痛がある．
		片頭痛を得る方法を減らすために，毎日薬剤を飲んでいる．
		片頭痛を引き起こすものが何かしっている．
		すぐには片頭痛薬を使用しないようにしている．
		過去数ヶ月間に片頭痛のため，学校，仕事を休んだり，その他の活動を見送ったことがある．
		過去 6ヵ月間で，片頭痛のために救急センターや救急外来に行かなくてはならないことがあった．
		自分の片頭痛治療に満足している．

作成者

飯ｹ谷美峰

13) Dowson AJ, Tepper SJ, Baos V, Baudet F, D'Amico D, Kilminster S. 　 Identifying patients who require a change in their current acute migraine 　 treatment: the Migraine Assessment of Current Therapy (Migraine-ACT) 　 questionnaire.Curr Med Res Opin. 2004 Jul;20(7):1125-35.
論文抄録	The aim of the study was to design and test a new, easy to use, assessment tool, the Migraine Assessment of Current Therapy (Migraine-ACT), for identifying patients who require a change in their acute treatment. A 27-item questionnaire was developed by an international advisory board including questions formulated in four domains: headache impact, global assessment of relief, consistency of response and emotional response. Migraine patients entered a multinational, prospective study to investigate the test-retest reliability and construct validity of the tool, which was completed by the patients on two occasions. Test-retest reliability was assessed by Pearson's and by Spearman correlation coefficients. Construct validity was assessed by correlating patients' answers to the 27-item questionnaire with those of well-reported measures: SF-36, MIDAS and Migraine Therapy Assessment Questionnaire (MTAQ). The test-retest reliability of the 27 initial questions ranged from good to excellent. Correlations of all items with SF-36, MIDAS and MTAQ scores--assessed by discriminatory t-tests--indicated that the following 4 were the most discriminating items: Does your migraine medication work consistently, in the majority of your attacks? Does the headache pain disappear within 2 hours? Are you able to function normally within 2 hours? Are you comfortable enough with your medication to be able to plan your daily activities? The 4-item Migraine-ACT is a brief, simple, and reliable assessment tool to identify patients who require a change in their acute migraine treatment, and can be recommended for primary care physicians, neurologists and headache clinicians.
文献 PubMed−ID	PMID: 15549559 [PubMed - in process]
エビデンスレベル	Ib
文献タイトル (日本語)	片頭痛の発作期に対する現行治療の変更を望む患者の同定：片頭痛の現行治療評価（ Migraine-ACT）質問票
目的	現在の片頭痛急性期治療が患者にとって十分であるか，変更が必要とされるか認識するための質問票を開発し，その評価をすること
研究デザイン	Validation studies
研究施設	英国，スペイン，ドイツ，イタリア，米国の頭痛センター
研究期間	2001年1月から2002年2月（January 2001 to February 2002.）
対象患者	18 歳から 65 歳の男女で少なくとも 1 年以上前から 1 ヶ月に 1-4 回の片頭痛発作を認め， 1 回ずつの間隔が 24 時間以上ある者を対象とした．また，明らかな精神疾患や依存症を有するものは除外した．
介入	質問票 27 項目の Migraine-ACT ， SF-36 ， QOL 質問票， MIDAS 質問票， MTAQ 質問票）は各々の国の言語に翻訳されたものを使用． HIS診断基準により片頭痛と診断された185人がテスト27項目Migraine-ACTの再テスト信頼性と妥当性を確立するために多国籍間での将来的，観察的調査にエントリーされた．前後1週間で2回Migraine-ACTを記入して再現性を評価，妥当性評価のために概念的に相関しているSF-36,MIDAS,MTAQ質問表に答えて，関連性を評価した．SF-36,MIDAS,MTAQから選別された4項目のMigraine-ACTの各質問を同定するためにｔ検定を用いた．この4項目が最終的なMigraine-ACTを構成した．
主要評価項目とそれに用いた統計学的手法	1週間間隔でMigraine-ACTを施行して試験再試験信頼性評価を行なった．Migraine-ACTの各質問項目について妥当性評価を行なった．すべての解析はStatistica softwareを用いて行なった．
結果	27項目のMigraine-ACTの再テスト試験の良好な結果を確認した．SF-36とMIDASの質問項目を含んだMigraine-ACTの相互関係とSF-36,MIDAS,MTAQの合計scoreから，4つのドメインがもっとも識別されることが示唆され，最終的なMigraine-ACT質問表が構成された．㈰作用の一貫性：あなたの片頭痛治療薬はほとんどの頭痛発作に対して一貫して有効ですか？㈪救済の包括的評価：頭痛は 2時間以内に消失しますか？㈫インパクト 2時間以内に通常の活動が可能となりますか？㈬情緒反応：現在の治療によって十分に快適な行動計画を立てることができますか？これらの 4項目Migaraine-ACTは非常に高い信頼性が示された．個々の質問と，4項目の合計スコアはSF-36,MIDAS,MTAQ質問表と高い相関関係を認め，特にMTAQとSF-36の合計で高かった．
結論	4項目のMigraine-ACT質問票は片頭痛の現行治療に変更が必要か同定するための評価toolである．簡便で記録しやすく，信頼性，正確性，明快性が示された．Migraine-ACTは臨床医の日常診療での使用が推奨される．
備考１	MeSH Terms: • Acute Disease • Adult • Analgesics/pharmacology* • Analgesics/therapeutic use • Drug Monitoring • Female • Humans • Male • Middle Aged • Migraine/drug therapy* • Migraine/physiopathology • Migraine/psychology • Pain Measurement* • Prospective Studies • Psychometrics/instrumentation* • Quality of Life • Questionnaires* • Research Support, Non-U.S. Gov't • Sickness Impact Profile* • Treatment Outcome*
備考２	Substances: Analgesics
備考 3	片頭痛 ACT質問票以下の 4つの質問に「はい」あるいは「いいえ」で答えてください．質問　　　　　　　　　　　　　㈰治療をうけたとき；あなたの片頭痛治療薬はほとんどの頭痛発作に対して一貫して有効ですか？　はい orいいえ㈪治療をうけたとき；頭痛は 2時間以内に消失しますか？　はいorいいえ㈫治療をうけたとき； 2時間以内に通常の活動が可能となりますか？　はいorいいえ㈬治療をうけたとき；現在の治療によって十分に快適な行動計画を立てることができますか？　はい orいいえ片頭痛 -ACT スコア　　　片頭痛 -ACT 質問票のスコアで1つ以上の「いいえ」があった場合，あなたの頭痛治療は変更が必要かもしれません．「いいえ」の数が増えるほど治療の必要性は増します．
作成者	飯ｹ谷美峰

Stewart WF, Lipton RB, Kolodner K, Liberman J, Sawyer J. Reliability of the migraine disability assessment score in a population-based sample of headache sufferers. Cephalalgia. 1999 Mar;19(2):107-14; discussion 74.
論文抄録	BACKGROUND: The Migraine Disability Assessment (MIDAS) score is used to quantify headache-related disability. In a previous study, we showed that the MIDAS score was highly reliable in population-based samples of migraine headache sufferers in two countries. OBJECTIVES: To examine the test-retest reliability and internal consistency of the five items comprising the MIDAS score and the overall MIDAS score in a population-based sample of both migraine and nonmigraine headache sufferers. METHODS: Using a clinically validated telephone interview, a population-based sample of migraine and nonmigraine headache sufferers was identified in Baltimore , Maryland , USA . A total of 97 migraine cases and 80 nonmigraine subjects completed the MIDAS questionnaire on two occasions an average of 3 weeks apart. The MIDAS score is derived from five questions about missed time from work (or school) and household work (one question each about missed days and days with at least 50% reduced productivity) and missed days of nonwork activities. RESULTS: Among all headache sufferers the test-retest Spearman's correlations of individual MIDAS questions ranged from 0.67 to 0.73. The Spearman's correlation for the MIDAS score (i.e., sum of lost days and reduced effectiveness days in each domain) was 0.84. Cronbach's alpha, a measure of internal consistency, was 0.83. Mean and median item values and the overall MIDAS scores differed between migraine and nonmigraine cases. Even after adjusting for differences in headache frequency, the mean MIDAS scores differed substantially (i.e., 10.3 points) between migraine cases and nonmigraine cases. CONCLUSIONS: The reliability and internal consistency of the MIDAS score are high, as tested in a population-based sample of headache sufferers. MIDAS scores are substantially higher in migraine cases than in non-migraine cases, supporting the validity of the measure.
文献 PubMed−ID	PMID: 10214536
エビデンスレベル	㈽
文献タイトル (日本語)	人口ベース標本の有頭痛者における片頭痛支障度評価スコアの信頼性
目的	5項目からなるMIDASスコアとMIDAS総スコアのテスト再テスト信頼性と内的整合性を人口ベースにおいて片頭痛患者と非片頭痛者で調査すること
研究施設	メリーランド州ボルチモア
研究期間	記載なし
対象患者	メリーランド州ボルチモアの住人
介入	メリーランド州ボルチモアの住人に電話インタビュー（ clinically validated computer-assisted telephone interview ;CATI）を行い対象者を集め，同意を得た後に信頼性調査に参加させた．対象者は3週間の前後で2回のMIDAS質問票を記入．
主要評価項目とそれに用いた統計学的手法	テスト再テストにおける各々の質問項目を Spearmanの相関係数で解析．内的整合性に関してはCronbachαを使用した．
結果	MIDAS質問票の各項目におけるSpearmanの相関係数は0.67から0.73だった．MIDASスコアのためのSpearman相関係数は0.84だった．Cronbachαで示される内的整合性は0.83．MIDASの総スコアの平均値と中央値は片頭痛患者と非頭痛者では差異があり，頭痛頻度を調整しても平均値は異なった．
結論	人口ベースサンプルの頭痛患者で試験されたように MIDASスコアの信頼性と内的整合性は高い．MIDASスコアは計測の妥当性を支持するように実質的に非頭痛者より片頭痛患者で高かった．
備考	MeSH Terms: • Adolescent • Adult • Disability Evaluation* • Female • Human • Male • Middle Aged • Migraine/physiopathology* • Pain Measurement • Questionnaires • Support, Non-U.S. Gov't
作成者	飯ｹ谷美峰

Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN. Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain. 2000 Oct;88(1):41-52.
論文抄録	The Migraine Disability Assessment (MIDAS) questionnaire is a brief, self-administered questionnaire designed to quantify headache-related disability over a 3 month period. The MIDAS score has been shown to have moderately high test-retest reliability in headache sufferers and is correlated with clinical judgment regarding the need for medical care. The aim of the study was to examine the validity of the MIDAS score, and the five items comprising the score, compared to data from a 90 day daily diary used, in part, to record acute disability from headache. In a population-based sample, 144 clinically diagnosed migraine headache sufferers were enrolled in a 90 day diary study and completed the MIDAS questionnaire at the end of the study. The daily diary was used to record detailed information on headache features as well as activity limitations in work, household chores, and non-work activities (social, family and leisure activities). The MIDAS score was the sum of missed work or school days, missed household chores days, missed non-work activity days, and days at work or school plus days of household chores where productivity was reduced by half or more in the last 3 months. Validity was assessed by comparing MIDAS items and the MIDAS score with equivalent measures derived from the diary. The MIDAS items for missed days of work or school (mean 0.96, median 0) and for missed days of household work (mean 3.64, median 2.0) were similar to the corresponding diary-based estimates of missed work or school (mean 1.23, median 0) and of missed household work (mean 3.93, median 2.01). Values for missed days of non-work activities (MIDAS mean 2.6 and median 1 versus diary mean 2.22 and median 0.95) were also similar. Responses to MIDAS questions about number of days where productivity was reduced by half or more in work (mean 3.77, median 2.00) and in household work (mean 3.92, median 2.00) significantly overestimated the corresponding diary-based measures for work (mean 2.94, median 1.06) and household work (mean 2.22, median 0.98). Nonetheless, the overall MIDAS score (mean 14.53, median 9.0) was not significantly different form the reference diary-based measure (mean 13.5, median 8.4). The correlation between the MIDAS summary score and an equivalent diary score was 0.63. The group estimate of the MIDAS score was found to be a valid estimate of a rigorous diary-based measure of disability. The mean and median values for the MIDAS score in a population-based sample of migraine cases were similar to equivalent diary measures. The correlation between the two measures was in the low moderate range, but expected given that two very different methods of data collection were compared.
文献 PubMed−ID	PMID: 11098098
エビデンスレベル	㈽
文献タイトル (日本語)	片頭痛もちの人口標本における MIDASスコアの妥当性
目的	MIDASスコアとスコアとなる5項目を90日間の頭痛日記から得られるデータと比較して妥当性を評価することである．
研究デザイン	Validation studies
研究施設	記載なし
研究期間	3 November 1997 and 10 December 1997 .
対象患者	メリーランド州ボルチモアの電話インタビューを受けた片頭痛もち 884 名のうちランダムに選ばれた 426 名
介入	メリーランド州ボルチモアの住人に電話インタビュー（ clinically validated computer-assisted telephone interview ;CATI）を行い対象者を集め，同意を得た後に妥当性調査に参加させた．対象者は90日間の頭痛日記を記入後MIDAS質問票を記入する．
主要評価項目とそれに用いた統計学的手法	MIDASの質問項目とスコアの妥当性を検討するため90日間の日記から得られるデータの平均値，中央値を算出
結果	仕事及び学校を休んだ日数およｂひ家事不能だった日数および仕事以外の活動が不能だった日数日記から得られた値と類似していた．仕事と家事の生産性が半減舌日数は MIDASスコアが日記スコアより過大評価されていた．全体のMIDASスコアは日記スコアと大きな差異は認められなかった．MIDASの合計スコアと日記から得られた合計スコアの相関は0.63だった．
結論	MIDASスコアで見積もられたグループは日記に基づいた支障度の計測値の見積もりと妥当であることが示された．人口ベース標本におけるMIDASスコアの平均値，中央値は日記の計測値と類似していた．
コメント	研究およびレポートの質は高い．
備考	Publication Types:　Validation studies MeSH Terms: • Absenteeism • Adult • Comparative Study • Disability Evaluation* • Efficiency • Female • Human • Male • Medical Records* • Middle Aged • Migraine/physiopathology* • Questionnaires • Support, Non-U.S. Gov't
作成者	飯ｹ谷美峰

大塚紀子 (北里大学大学院医療系研究科臨床医科学群内科III), 坂井文彦, 飯ヶ谷美峰, 五十嵐久佳, 白鷹増男 . 北里医学 (0385-5449)33巻2号 Page149-157(2003.04)
論文抄録	片頭痛 62例を対象に,外来受診時に面談を行い,トリプタン使用前後でMIDAS質問票日本語版,HIT-6日本語訳を用いて支障度を測定した.トリプタン使用前のMIDASスコアの平均は27.2日で,使用後のMIDASスコアの平均は15.5日と約11.6日スコアが低下した.MIDASスコアの変化率は使用後で43%減少し支障度の改善が認められた.トリプタン使用前のHIT-6Sスコアの平均は65.5で,使用後の平均は59.7と約5.8スコアが低下した.HIT-6スコアの変化率は使用後8.9%減少し,頭痛にかかわる影響度の改善が認められた.MIDASにない項目で,HIT-6の「頭痛のせいでうんざりしたり,いらいらしたことがあったか」は,トリプタン使用後に減少したが,HIT-6の他の生活支障度や頭痛強度の質問項目に比べ,変化が軽度であった.MIDASと比べHIT-6には精神面での評価項目があり,スコアが高くなる傾向があった.同時期・同一患者のMIDASスコアとHIT-6スコアの相関はトリプタン使用前で0.29,トリプタン使用後で0.37と弱い相関関係であった
文献 PubMed−ID	2004213596
エビデンスレベル	㈽
文献タイトル (日本語)	トリプタンによる片頭痛支障度・ QOL改善評価　MIDAS・HIT-6スコアを用いて
目的	片頭痛患者の支障度をトリプタン使用前後で測定する
研究施設	北里大学病院神経内科
対象患者	北里大学病院神経内科外来通院中の片頭痛患者 62例
介入	トリプタンによる治療の前後に対象患者に MIDAS質問票日本語版,HIT-6日本語訳を記入してもらう．
備考１	シソーラス用語：片頭痛 (薬物療法); 生活の質; Serotonin Agonists(治療的利用,薬理学); 治療成績; アンケート; Sumatriptan(治療的利用,薬理学); Zolmitriptan(治療的利用,薬理学); Eletriptan(治療的利用,薬理学); 経口投与医中誌フリーキーワード：トリプタン系薬剤 (治療的利用,薬理学)
備考２	Publication Types: 原著論文
結果	トリプタン使用前の MIDASスコアの平均は27.2日で,使用後のMIDASスコアの平均は15.5日と約11.6日スコアが低下した.MIDASスコアの変化率は使用後で43%減少し支障度の改善が認められた.トリプタン使用前のHIT-6Sスコアの平均は65.5で,使用後の平均は59.7と約5.8スコアが低下した.HIT-6スコアの変化率は使用後8.9%減少し,頭痛にかかわる影響度の改善が認められた.MIDASにない項目で,HIT-6の「頭痛のせいでうんざりしたり,いらいらしたことがあったか」は,トリプタン使用後に減少したが,HIT-6の他の生活支障度や頭痛強度の質問項目に比べ,変化が軽度であった.MIDASと比べHIT-6には精神面での評価項目があり,スコアが高くなる傾向があった.同時期・同一患者のMIDASスコアとHIT-6スコアの相関はトリプタン使用前で0.29,トリプタン使用後で0.37と弱い相関関係であった
作成者	飯ｹ谷美峰

Hershey AD, Powers SW, Vockell AL, LeCates S, Kabbouche MA, Maynard MK.PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology. 2001 Dec 11;57(11):2034-9.
論文抄録	BACKGROUND: For adults, disability produced by migraines has been assessed with a migraine-specific disability tool-MIDAS. The objective of this study was to develop and validate a similar tool that accurately depicts the disability of headaches in school-age children and adolescents. METHODS: A six-question tool (PedMIDAS) was developed and administered to patients attending a tertiary referral center for pediatric headaches. Internal consistency and test/retest reliability were assessed. Validity was assessed by correlating scores with headache frequency, severity, and duration. Changes in the total score in response to treatment were assessed in a portion of the patients. RESULTS: The PedMIDAS questionnaire was administered to 441 patients for a total of 724 trials. The mean score at the initial visit was 44.3 +/- 47.9, whereas the overall mean score was 25.1 +/- 36.5. A 2-week test/retest reliability assessment for 56 patients confirmed the stability of the instrument with a Pearson coefficient of 0.80. The correlation of the PedMIDAS score with frequency, severity, and duration had Pearson's coefficient values of 0.58, 0.27, and 0.23. The PedMIDAS score was reduced to 20.0 +/- 32.3 (p < 0.0001) at the first follow-up assessment with subsequent continued reduction. CONCLUSIONS: The PedMIDAS questionnaire provided a developmentally sensitive, reliable, and valid assessment of the disability of childhood and adolescent headaches. This questionnaire provides a tool to assess the impact of migraines in children and to monitor response to treatment. Further research should focus on additional validation of the PedMIDAS using a larger population and sampling from other populations (e.g., primary care and community samples).
エビデンスレベル	㈽
文献 PubMed−ID	PMID: 11739822
文献タイトル (日本語)	PedMIDAS:小児における片頭痛の支障度評価のための質問票の展開
目的	学童期の小児と思春期の若者における頭痛の支障を正確に表すツールを開発する
研究デザイン	open, prospective, multinational, observational, two-visit study,
研究施設	頭痛センターあるいはシンシナティ子供病院メディカルセンターのサテライト施設
研究期間	記載なし
対象患者	片頭痛と臨床診断された小児 441名
主要評価項目とそれに用いた統計学的手法	正常化分布を用いたｚスコアと pスコアを応用した平均値と標準偏差を統計解析に使用．試行と観察の連続の比較にPearson相関係数を使用．
結果	合計 724のトライアルのため441人の患者にPedMIDAS質問票が施された．56名の患者で行ったテスト再テスト信頼性調査はPearson相関係数で0.80でツールとしての安定性が示された．頻度，重症度，期間によるPedMIDASスコアのPearson係数はそれぞれ0.58,0.27,0.23だった．
結論	PedMIDAS質問票はは小児期と思春期の子供の頭痛による支障度を評価するのに感度，信頼性，妥当性が高い．質問票は小児における頭痛の影響を評価したり，治療の反応性をモニターしたりするツールとなる．
備考	MeSH Terms: • Adolescent • Child • Child, Preschool • Cohort Studies • Disability Evaluation* • Female • Human • Male • Migraine/diagnosis* • Psychometrics • Quality of Life • Reproducibility of Results • Sickness Impact Profile*
作成者	飯ｹ谷美峰

Bayliss MS, Dewey JE, Dunlap I, Batenhorst AS, Cady R, Diamond ML, Sheftell F. A study of the feasibility of Internet administration of a computerized health survey: the headache impact test (HIT).Qual Life Res. 2003 Dec;12(8):953-61
論文抄録	BACKGROUND: Headache impact test (HIT) is a precise, practical tool that quantifies the impact of headache on respondents' lives. It is the first widely-available dynamic health assessment (DynHA). Applications of this brief, precise survey include population based screening for disabling headaches, tracking of individual patient scores over time, disease management programs and others. We use data from Internet HIT assessments during the fall of 2000 to (1) evaluate characteristics of respondents and assessments, (2) assess the utility of joint administration of HIT and the SF-8 Health Survey (SF-8) to screen for migraine and depression, and (3) explore associations between HIT scores and subsequent healthcare-related attitudes and behaviors. METHODS: We analyzed Internet HIT surveys completed between 9/1 and 11/30/2000 (n = 19,195). Subsamples include respondents who also completed (1) a 12-item Internet survey assessing severity, frequency, cause and management of headaches; (2) an e-mail survey measuring healthcare-related behaviors; (3) the SF-8; or (4) the website registration process, providing age and gender data. We used analysis of variance (ANOVA) to evaluate HIT score differences associated with age, gender, headache severity or frequency, and healthcare-related behaviors and attitudes and chi2 tests to assess the prevalence and comorbidity of migraine and depression. RESULTS: Three-quarters of respondents achieved a precise HIT score in < or = 5 items. Most had moderate/severe headaches; 65% had headaches at least monthly. HIT scores were directly related to headache severity and frequency. Most respondents were females, with significantly higher HIT scores than males. Most HIT respondents were between ages 25 and 54 (HIT scores were higher for younger respondents). Sixty four percent screened positive for migraine; 20% for depression. Both conditions were more prevalent among females than males. Comorbid migraine and depression was 50% more prevalent among females and increased with age until age 50. Patients with worse headache impact were more likely to seek care, discuss headaches with their providers and find HIT useful. CONCLUSIONS: It is feasible to use Internet-based dynamic assessments to measure health status. These data complement previous results showing that HIT differentiates respondents according to headache characteristics (severity and frequency). HIT plus SF-8 yields a practical screen for migraine and depression in headache patients and may lead to more effective treatment for patients with these conditions. Preliminary findings suggest that the experience of taking HIT on the Internet may motivate headache patients to seek care and discuss headaches with their providers.
文献 PubMed−ID	PMID: 14651414
エビデンスレベル	㈽
文献タイトル (日本語)	インターネットで行なうコンピュータ化された健康調査の実用性についての研究； Headahce Impact Test(HIT)
目的	インターネットにおける HITのデータをもとに回答者とその評価の特徴を評価する．片頭痛とうつのスクリーニングの
研究デザイン	Internet survey
研究施設	不明
研究期間	2000年9月1日〜11月30日
介入	19195名に電話調査を行った． Internet Study;12項目の重度，頻度，原因，頭痛管理，を評価 Email Survey：ヘルスケア関連の行動の測定（SF8） Analysis of Variance(ANOVA)
主要評価項目とそれに用いた統計学的手法	年齢・性別・頭痛の重度と頻度，ヘルスケア関連行動に関連した HITスコアの違いを評価． Chi2 test：片頭痛とうつの有病率とcomorbidityを評価する．
結果	中等度から十度の片頭痛はほとんどの症例． 65％は少なくとも連日の頭痛を有していた．
結論	健康状態を計測するためインターネットベースの評価法と HITは実用可能である．
備考１	MeSH Terms: • Adolescent • Adult • Aged • Computer Systems • Feasibility Studies • Female • Headache/physiopathology* • Humans • Internet* • Male • Middle Aged • Psychometrics • Quality of Life • Questionnaires* • Sickness Impact Profile*
備考２	HITへのアクセス www.amIhealthy.com , www.headachetest.com ,
作成者	飯ｹ谷美峰

Kosinski M, Bayliss MS, Bjorner JB, Ware JE Jr, Garber WH, Batenhorst A, Cady R, Dahlof CG, Dowson A, Tepper S. A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res. 2003 Dec;12(8):963-74.
論文抄録	BACKGROUND: Migraine and other severe headaches can cause suffering and reduce functioning and productivity. Patients are the best source of information about such impact. OBJECTIVE: To develop a new short form (HIT-6) for assessing the impact of headaches that has broad content coverage but is brief as well as reliable and valid enough to use in screening and monitoring patients in clinical research and practice. METHODS: HIT-6 items were selected from an existing item pool of 54 items and from 35 items suggested by clinicians. Items were selected and modified based on content validity, item response theory (IRT) information functions, item internal consistency, distributions of scores, clinical validity, and linguistic analyses. The HIT-6 was evaluated in an Internet-based survey of headache sufferers (n = 1103) who were members of America Online (AOL). After 14 days, 540 participated in a follow-up survey. RESULTS: HIT-6 covers six content categories represented in widely used surveys of headache impact. Internal consistency, alternate forms, and test-retest reliability estimates of HIT-6 were 0.89, 0.90, and 0.80, respectively. Individual patient score confidence intervals (95%) of app. +/-5 were observed for 88% of all respondents. In tests of validity in discriminating across diagnostic and headache severity groups, relative validity (RV) coefficients of 0.82 and 1.00 were observed for HIT-6, in comparison with the Total Score. Patient-level classifications based in HIT-6 were accurate 88.7% of the time at the recommended cut-off score for a probability of migraine diagnosis. HIT-6 was responsive to self-reported changes in headache impact. CONCLUSIONS: The IRT model estimated for a 'pool' of items from widely used measures of headache impact was useful in constructing an efficient, reliable, and valid 'static' short form (HIT-6) for use in screening and monitoring patient outcomes.
文献 PubMed−ID	PMID: 14651415
エビデンスレベル	㈽
文献タイトル (日本語)	頭痛のインパクトを計測するための 6項目のショートフォーム調査：HIT-6
目的	臨床研究や診療において患者のスクリーニングやモニタリングに使用しうる信頼性，妥当性を有する簡潔で幅広い内容を持った頭痛インパクトを評価する HIT-6の開発をする．
介入	HIT-6能項目は既存の54項目と臨床かによって提案された35項目から選択された．選択項目は妥当性，項目反応セオリー（IRT）情報機能，内的整合性，スコアの配分，言語的分析に基づいて修正された．HIT-6はアメリカオンライン（AOL）のメンバーからなる1103名の頭痛患者のインターネット調査で評価された．14日後の540名に対して追跡調査を行なった．
結果	HIT-6の内的整合性；0.89，交替配列型0.90，試験再試験信頼度0.80であった．
結論	頭痛のインパクトを計測するために広く用いられている項目を見積もる IRTモデルは，患者の成果をスクリーニングしたりモニタリングするための，有効で信頼性と妥当性を有するショートフォーム（HIT-6）を構築するのに有用であった．
備考	MeSH Terms: • Adult • Calibration • Headache/physiopathology* • Humans • Internet* • Psychometrics • Quality of Life • Questionnaires* • Sickness Impact Profile* • United States
作成者	飯ｹ谷美峰

Wagner TH, Patrick DL, Galer BS, Berzon RA. A new instrument to assess the long-term quality of life effects from migraine: development and psychometric testing of the MSQOL..Headache. 1996 Sep;36(8):484-92.
論文抄録	Quality of life is important to persons experiencing migraine. This study discusses the development of a migraine-specific quality-of-life measure (MSQOL). Participants, who included migraineurs from both tertiary care centers and the community, were screened using the International Headache Society migraine criteria prior to enrollment. Internal consistency of the MSQOL was high (alpha 0.92). Reproducibility over an average of 24 days was high (intraclass correlation 0.90). Construct validity was determined by convergent validity and known groups validity. The MSQOL was compared to two other frequently used health status questionnaires; results indicate that the MSQOL more closely resembles well-being than functional status. Results also indicate that migraineurs with more symptoms, medical appointments per year to treat migraines, and migraine episodes per year have a significantly worse quality of life. The MSQOL proved valid and reliable as a self-administered measure and will be a useful tool in clinical migraine research. The information gained from its use in the clinical environment should provide important additional information about the impact of migraine on quality of life and the potential benefits of therapeutic interventions.
文献 PubMed−ID	PMID: 8824004
エビデンスレベル	㈽
文献タイトル (日本語)	片頭痛から影響を受ける長期的 QOLを評価するための新しい道具；MSQOLの開発と心理測定的テスト
目的	片頭痛患者にとっての QOL測定法の開発について検討する．
対象患者	シアトル地域の住民を対象に公共掲示板や広告を用いて参加者を募集，そのうちの 175人の片頭痛患者を選定．
介入	1.片頭痛に特異的な質問群の開発， 2.質問票試案の構成と改良， 3.MSQOLの心理測定的テストを行なった．
主要評価項目とそれに用いた統計学的手法	内的整合性評価（ Cronbach α），再現性調査（クラス内相関係数）
結果	MSQOLの内的整合性は高かった（Cronbach α0.92）平均24日の再現性はクラス内相互関係0.90で高かった．MSQOLと他のの2種類の健康状態アンケートを比較したところ，MSQOLがより機能的な
結論	長期の治療転帰を評価するとき， MSQOLには片頭痛患者の生活の質に関する有益な情報を提供して，役立つ補助計測である可能性がある．
備考	MeSH Terms: • Adult • Comparative Study • Female • Health Status Indicators* • Humans • Male • Migraine/complications • Migraine/physiopathology • Migraine/psychology • Psychometrics • Quality of Life • Questionnaires/standards • Reproducibility of Results • Research Support, Non-U.S. Gov't
作成者	飯ｹ谷美峰

Martin BC, Pathak DS, Sharfman MI, Adelman JU, Taylor F, Kwong WJ, Jhingran P. Validity and reliability of the migraine-specific quality of life questionnaire (MSQ Version 2.1). Headache. 2000 Mar;40(3):204-15.
論文抄録	OBJECTIVE: To assess the scaling properties, reliability, and validity of the revised Migraine-Specific Quality of Life Questionnaire (MSQ) (Version 2.1) BACKGROUND: The MSQ is a disease-specific, quality-of-life instrument with three hypothesized scales that has been developed, tested, and revised. METHODS: The study used a multicenter, nondrug, prospective, parallel group, quasi-experimental design. Patients with migraine were recruited at outpatient headache specialty practices and were administered the MSQ, the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and migraine symptom questionnaires at baseline, 4 weeks, and 12 weeks. Internal consistency (Cronbach alpha) and 4-week test-retest reproducibility (intraclass correlation coefficients) were estimated to assess reliability. Construct validity was assessed using an adaptation of the Campbell and Fiske multitrait-multimethod approach and by correlating MSQ scores with symptom measures. RESULTS: A total of 267 subjects enrolled in the trial. The criteria for summated rating scales were all met. The internal consistency coefficients ranged from 0.86 to 0.96, and the intraclass correlation coefficients ranged from 0.57 to 0.63 across the three dimensions. As anticipated, the MSQ dimensions had low-to-modest correlations with the two component scores of the SF-36 and were modestly to moderately correlated with migraine symptoms. CONCLUSIONS: The MSQ is a reliable instrument in the assessment of quality of life for patients with migraine with items that can be summed without weights. The MSQ has demonstrated evidence of construct validity.
文献 PubMed−ID	PMID: 10759923
エビデンスレベル	㈽
文献タイトル (日本語)	片頭痛に特異的な QOL質問票（MSQ2.1）の妥当性と信頼性
文献タイトル（英語）	Validity and reliability of the migraine-specific quality of life questionnaire (MSQ Version 2.1).
目的	改定版 MSQの計測特性と信頼性，妥当性を評価する．
研究デザイン	Multicenter Study
研究施設	多施設
対象患者	複数の頭痛専門外来における未治療の片頭痛患者を対象とした．
介入	片頭痛患者に治療の前， 4週間後，12週間後の医療的結果をMSQおよびSF-36を用いて評価した．
主要評価項目とそれに用いた統計学的手法	信頼性評価；内的整合性（ Cronbach α）と試験再試験再現性（クラス内相関係数）妥当性評価； CampbellとFiskeのmustitrait-multimethodアプローチ適合を用いて評価
結果	267人がトライアルに登録された．内的整合性係数は 0.86〜0.96，クラス内相関係数は0.57〜0.65だった．
結論	MSQver2.1は片頭痛患者のQOLを評価するために高い信頼性を有する道具である．MSQの構造的妥当性の証拠が示された．
備考	MeSH Terms: • Evaluation Studies • Humans • Migraine/physiopathology* • Prospective Studies • Quality of Life* • Questionnaires/standards* • Reproducibility of Results • Research Support, Non-U.S. Gov't

Chatterton ML, Lofland JH, Shechter A, Curtice WS, Hu XH, Lenow J, Smullens SN, Nash DB, Silberstein SD. Reliability and validity of the migraine therapy assessment questionnaire. Headache. 2002 Nov-Dec;42(10):1006-15