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Review paper
Received: 15.03.2019. >> Accepted: 10.04.2019. >> Published: 10.05.2019. Biochemistry
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https://doi.org/10.17392/1021-19

Screening general practice patients for migraine without aura: construction and validation of the Balkan Migraine Screening Questionnaire (BMSQ)

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Aziz Šukalo ,
Aziz Šukalo

Bosnalijek JSC, Sarajevo, Sarajevo, Bosnia and Herzegovina

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Elma Merdžanović ,
Elma Merdžanović

Health Care Centre of Canton Sarajevo, Hadžići, Bosnia and Herzegovina

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Alma Alic ,
Alma Alic

Health Care Centre Zenica, Zenica, Bosnia and Herzegovina

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Muamera Vrabac-Mujčinagić ,
Muamera Vrabac-Mujčinagić

Health Care Centre Tuzla, Tuzla, Bosnia and Herzegovina

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Esad Alibašić ,
Esad Alibašić

Health Care Centre, Kalesija, Kalesija, Bosnia and Herzegovina

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Slobodan M. Janković Orcid logo
Slobodan M. Janković
Contact Slobodan M. Janković

University of Kragujevac, School of Medical Sciences, Kragujevac, Serbia

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Abstract

Aim
 To develop and validate a screening questionnaire for migraine without aura with sufficient diagnostic accuracy to be used in primary care settings.
Methods
 The study was designed as cross-sectional, multicentric, diagnostic accuracy trial of new questionnaire for screening patients who visit general practitioners, with an aim to reveal migraine without aura. The instrument was constructed for the purpose of this study, and validated on the sample of 429 primary care outpatients. The gold standard of diagnosing migraine without aura was clinical estimate by a neurologist based on the International Classification of Headache Disorders 3rd edition (ICHD-III) criteria. Diagnostic accuracy of the instrument was tested through construction of the Receiver Operator Curve.
Results
 The Balkan Migraine Screening Questionnaire (BMSQ) instrument showed good diagnostic accuracy (sensitivity 83.4%
and specificity 79.9%) for migraine without aura, with significant screening yield among previously undiagnosed patients of 75.9%. The study also confirmed a high percentage of patients with hidden migraine without aura (MWA) (52.9%) revealed by the BMSQ and the ICHD-III criteria that would otherwise remain undiagnosed.
Conclusion
 The BMSQ is a valid and reliable clinical instrument for revealing migraine without aura, which could be easily selfadministered by patients. It has high screening yield, discovering majority of patients with previously undiagnosed migraine without aura, whose definite diagnosis should later on be confirmed by the attending physicians using the ICHD-III criteria. 

Keywords:

diagnosis,
migraine without aura,
questionnaire design,
screening migraine disorders,
validation studies

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