E-diary use in clinical headache practice: A prospective observational study

Cephalalgia, vol. 41, pp. 1161–1171

Abstract

AIM: To determine whether our E-diary can be used to diagnose migraine and provide more reliable migraine-related frequency numbers compared to patients' self-reported estimates. METHODS: We introduced a self-developed E-diary including automated algorithms differentiating headache and migraine days, indicating whether a patient has migraine. Reliability of the E-diary diagnosis in combination with two previously validated E-questionnaires was compared to a physician's diagnosis as gold standard in headache patients referred to the Leiden Headache Clinic (n = 596). In a subset of patients with migraine (n = 484), self-estimated migraine-related frequencies were compared to diary-based results. RESULTS: The first migraine screening approach including an E-headache questionnaire, and the E-diary revealed a sensitivity of 98% and specificity of 17%. In the second approach, an E-migraine questionnaire was added, resulting in a sensitivity of 79% and specificity of 69%. Mean self-estimated monthly migraine days, non-migrainous headache days and days with acute medication use were different from E-diary-based results (absolute mean difference ± standard deviation respectively 4.7 ± 5.0, 6.2 ± 6.6 and 4.3 ± 4.8). CONCLUSION: The E-diary including algorithms differentiating headache and migraine days showed usefulness in diagnosing migraine. The use emphasised the need for E-diaries to obtain reliable information, as patients do not reliably recall numbers of migraine days and acute medication intake. Adding E-diaries will be helpful in future headache telemedicine.

Authors 8

1. Daphne S. van Casteren Aachen Department of Neurology, Leiden University Medical Center (LUMC)

   Leiden University Medical Center · Erasmus MC

   Affiliation as printed

   Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

   Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

2. Iris E. Verhagen Aachen Department of Neurology, Leiden University Medical Center (LUMC)

   Leiden University Medical Center · Erasmus MC

   Affiliation as printed

   Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

   Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

3. Irene de Boer Aachen Department of Neurology, Leiden University Medical Center (LUMC)

   Leiden University Medical Center

   Affiliation as printed

   Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

4. Simone de Vries Lentsch Aachen Department of Neurology, Leiden University Medical Center (LUMC)

   Leiden University Medical Center · Erasmus MC

   Affiliation as printed

   Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

   Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

5. Rolf Fronczek Aachen Department of Neurology, Leiden University Medical Center (LUMC)

   Leiden University Medical Center

   Affiliation as printed

   Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

6. Erik W. van Zwet Aachen Department of Medical Statistics

   Leiden University Medical Center

   Affiliation as printed

   Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands

7. Antoinette MaassenVanDenBrink

   Erasmus MC

   Affiliation as printed

   Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

8. Gisela Marie Terwindt corresponding Aachen Department of Neurology, Leiden University Medical Center (LUMC)

   Leiden University Medical Center

   Affiliation as printed

   Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands