No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Reliability and validity of migraine disability assessment questionnaire-Thai version (Thai-MIDAS)
Abstract
To assess the validity and test-retest reliability of a Thai translation of the Migraine Disability Assessment (MIDAS) Questionnaire in Thai patients with migraine.
Migraineurs from the Headache Clinic in Siriraj Hospital were recruited and asked to complete a 13-weeks diary and answered the Thai-MIDAS at once. Some participants were asked to provide the 2nd Thai-MIDAS in the next 2 weeks for test-retest reliability.
Ninety-three patients had completed the 13-weeks diaries. Age range was 18-58 years with mean 37.69 +/- 9.60 years. All 5 items and the total score of Thai-MIDAS were moderately correlated with data from 13-weeks diary (Spearman's correlation coefficient = 0.32-0.62). The test-retest reliability of the total score of Thai-MIDAS in 30 patients demonstrated a highly reliable degree of intraclass correlation (ICC = 0.76, 95% CI 0.49-0.88).
The present study reveals that the Thai-MIDAS has satisfactory validity and reliability in comparison with the original English MIDAS version.
... In Thailand, the Thai-version MSQ 2.1 has been used to assess QoL of people with migraine [26], but a translation of a questionnaire specific for assessing migraine-related disability has not been available. Two Thai versions of the MIDAS questionnaire have been published, one in 2013, and the other in 2018 [27,28]. The first Thai questionnaire was only tested for content equivalence to the original English version by professional translators and medical specialists, but was not tested for language equivalence. ...
... The first Thai questionnaire was only tested for content equivalence to the original English version by professional translators and medical specialists, but was not tested for language equivalence. In addition, the 5 items and the total score of that Thai questionnaire had only weak-to-strong criterion validity as measured by Spearman correlation coefficients and fair-to-excellent test-retest reliability as measured by intraclass correlation coefficient (ICC) [27]. Moreover, the questionnaire was not tested for internal consistency. ...
... There have been 9 non-English versions of the MIDAS questionnaire, with Italian [31], Japanese [32], Turkish [33,34], Taiwanese [35], Thai [27,28], Arabic [36], Greek [37], German [38], and Spanish [39] versions that have been previously reported ( Table 7). The development process for a non-English version from an original English version questionnaire included forward and backward translation. ...
Background
A Thai-version of the Migraine Specific Quality of Life Questionnaire (MSQ 2.1) is available, but a qualified questionnaire used specifically for disability assessment was not available. The most relevant practical disability assessment tested during this study was the Migraine Disability Assessment (MIDAS) Questionnaire.
Objectives
To test the concurrent validity, test–retest reliability, and internal consistency of a Thai-version MIDAS questionnaire, and factors to predict disability in people with migraine.
Methods
We conducted the present prospective study at a tertiary care teaching hospital in Bangkok. The original English MIDAS Questionnaire was translated into Thai with back-translation into English and the language equivalence was assessed. The Thai-version MIDAS Questionnaire was tested for concurrent validity, test–retest reliability, and internal consistency, and factors including duration of migraine history, migraine characteristics, and comorbidity were assessed for the ability to predict migraine-related disability of migraineurs.
Results
Of the 58 participants, 31 were eligible to be included. The validity of the Thai-version questionnaire between the MIDAS total score and the mean headache severity (question B), the mean pain duration per attack, and the mean pain numerical rating scale (NRS) score were moderately correlated with a Spearman correlation coefficient range 0.42–0.58. The test–retest reliability of MIDAS grade had a weighted κ of 0.66, and for individual questions of the MIDAS total score, questions A and B assessed by intraclass correlation coefficients ranged 0.89–0.98. The internal consistency had a Cronbach α of 0.98. The mean pain NRS score in the past 3 months was an independent predictive factor for migraine-related disability.
Conclusion
The Thai-version MIDAS Questionnaire has moderate concurrent validity, acceptable internal consistency, and excellent test–retest reliability. It would be helpful to assess clinical outcomes. Future study with a standardized translation process for the Thai-version questionnaire and a larger sample size is warranted to confirm internal consistency and determine all probable predictive factors for migraine-related disability.
... to evaluate the impact of migraine and has been proven simple to use, consistent, highly reliable, and correlating well with physicians' clinical judgments in several studies, not only in USA and UK English [6,8], but also in many other languages. Among such languages, we may cite, by alphabetic order, Arabic [9], Chinese [10], French [11], German [12], Greek [13], Hindi [14], Italian [15], Japanese [16], Malay [17], Persian [18], Portuguese-Brazil [19], Spanish [20], Thay [21], and Turkish [22]. MIDAS also proved to be useful to identify adequate treatments and to stratify them based on the level of patient disability [9,23]. ...
... In what concerns validity, mMIDAS-P results are, in general, comparable with other validation studies, even with different methodology. UK and USA [5], Japan [16] and Thailand [21], compared their results with 90-day diary measures patients were supposed to fill; some studies did it with HIT-6 as Hindi version [14], and some others with SF-12, SF-36 or RAND-36, as the Persian [18] or Greek [13] versions. However, as far as we know, our version is the first one comparing MIDAS scores with psychological indicators and preferencebased QoL measures. ...
Background
Migraine Disability Assessment Scale (MIDAS) is a useful tool to measure headache-related disability. Modified MIDAS with 4-week recall period reduces recall bias and improves accuracy of the results. This study aimed at validating mMIDAS in Portuguese.
Methods
Studied population consisted of adult migraine patients attending a headache outpatient clinic. Reliability was assessed by internal consistency and reproducibility in a 3-week test-retest. Content validity was evaluated by two expert panels. Construct validity was tested by comparing mMIDAS-P index in socioeconomic and clinical patient groups and scale unidimensionality was evidenced by factor analysis. Criterion validity was tested using EQ-5D-5L and HADS.
Results
Ninety-two patients, 88% female, mean age of 44 years, participated. They had, in average, 9.7 headache days in previous month, pain averaging 7.5/10. About 69.9% were on a migraine prophylactic treatment, and 42.4% had severe disability; 29.4 and 13.0% showed, respectively, moderate/severe anxiety and depression. Content validity showed that mMIDAS-P is simple and clinically useful. It did not show to be determined by patient’s sociodemographic characteristics and it was correlated with depression scale and EQ-5D-5L. Test-retest demonstrated high reproductive reliability and good internal consistency.
Conclusion
mMIDAS-P is valid and reliable. We strongly recommend it for clinical and research use.
... Reliability and validity of the MIDAS questionnaire have been tested extensively in numerous studies in various countries and in different languages [4,7,[11][12][13][14][15][16][17][18][19][20]. A German version of the MIDAS was published by Agosti et al. in 2008 [21]. ...
... The original MIDAS has been translated into several languages and the reliability of the Chinese [13], French [14], Hindi [15], Japanese [16], Malay [17], Persian [18], Thai [19], and Turkish [20] versions has been tested. The test-retest Pearson or Spearman correlation coefficients in the different versions ranged from 0.84 to 0.87 for single items of the MIDAS and from 0.65 to 0.94 for the MIDAS total score. ...
Background:
The Migraine Disability Assessment (MIDAS) is a brief questionnaire and measures headache-related disability. This study aimed to translate and cross-culturally adapt the original English version of the MIDAS to German and to test its reliability.
Methods:
The standardized translation process followed international guidelines. The pre-final version was tested for clarity and comprehensibility by 34 headache sufferers. Test-retest reliability of the final version was quantified by 36 headache patients completing the MIDAS twice with an interval of 48 h. Reliability was determined by intraclass correlation coefficients and internal consistency by Cronbach's α.
Results:
All steps of the translation process were followed, documented and approved by the developer of the MIDAS. The expert committee discussed in detail the complex phrasing of the questions that refer to one to another, especially exclusion of headache-days from one item to the next. The German version contains more active verb sentences and prefers the perfect to the imperfect tense. The MIDAS scales intraclass correlation coefficients ranged from 0.884 to 0.994 and was 0.991 (95% CI: 0.982-0.995) for the MIDAS total score. Cronbach's α for the MIDAS as a whole was 0.69 at test and 0.67 at retest.
Conclusions:
The translation process was challenged by the comprehensibility of the questionnaire. The German version of the MIDAS is a highly reliable instrument for assessing headache related disability with moderate internal consistency. Provided validity testing of the German MIDAS is successful, it can be recommended for use in clinical practice as well as in research.
... Table 7 In what concerns validity, mMIDAS-P results are, in general, comparable with other validation studies, even with different methodology. UK and USA [5], Japan [16] and Thailand [21], compared their results with 90-day diary measures patients were supposed to ll; some studies did it with HIT-6 as Hindi version [14], and some others with SF-12, SF-36 or RAND-36, as the Persian [18] or Greek [13] versions. However, as far as we know, our version is the rst one comparing MIDAS scores with psychological indicators and preference-based QoL measures. ...
Background
Migraine Disability Assessment Scale (MIDAS) is a useful tool to measure headache-related disability. Modified MIDAS with 4-week recall period reduces recall bias and improves accuracy of the results. This study aimed at validating mMIDAS in Portuguese.
Methods
Studied population consisted of adult migraine patients attending a headache outpatient clinic. Reliability was assessed by internal consistency and reproducibility in a 3-week test-retest. Content validity was evaluated by two expert panels. Construct validity was tested by comparing mMIDAS-P index in socioeconomic and clinical patient groups and scale unidimensionality was evidenced by factor analysis. Criterion validity was tested using EQ-5D-5L and HADS.
Results
92 patients, 88% female, mean age of 44 years, participated. They had, in average, 9.7 headache days in previous month, pain averaging 7.5/10. About 69.9% were on a migraine prophylactic treatment, and 42.4% had severe disability; 29.4% and 13.0% showed, respectively, moderate/severe anxiety and depression. Content validity showed that mMIDAS-P is simple and clinically useful. It did not show to be determined by patient’s sociodemographic characteristics and it was correlated with depression scale and EQ-5D-5L. Test-retest demonstrated high reproductive reliability and good internal consistency.
Conclusion
mMIDAS-P is valid and reliable. We strongly recommend it for clinical and research use.
... Compared to an earlier Thai study completed with 29 patients, around 54 patients collected in our study demonstrated a high degree of reliability. 27 We also compared the mean of the total MIDAS scores between the first and second visits in all patients to assess test-retest reliability of MIDAS. High overall correlations were found with the correlation coefficient of 0.81 (95% CI 0.69-0.88). ...
Introduction:
Patients with migraine have varying medical care needs. To effectively stratify patients to appropriate care, physicians should consider the frequency and intensity of attacks, and their overall impact on ability to function. The Migraine Disability Assessment Scale (MIDAS) measures headache-related disability. The MIDAS Perceptions Study investigated whether MIDAS scores reflect headache severity and the need for medical care, and assessed whether the MIDAS questionnaire is meaningful and relevant to patients, and easy to use.
Design:
The Perceptions Study was conducted as a follow-up to a baseline telephone interview. Upon completion of the baseline survey, 471 individuals were invited to participate in the Perceptions Study and 420 participated: 168 patients with migraine headaches and 253 with non-migraine headaches. Patients with migraine or non-migraine headaches completed the MIDAS questionnaire and the Center of Epidemiologic Studies of Depression (CES-D) questionnaire, and were then interviewed by telephone within 48 hours of receiving the questionnaires.
Results:
Headache frequency and pain intensity increased significantly with increasing MIDAS grade (p < 0.0001). A pattern of decreasing quality-of-life scores on the physical and mental subscales of the Short Form-12 was also seen with increasing MIDAS grade. Scores on the CES-D scale increased significantly with increasing MIDAS grade (p < 0.0001), indicating a greater likelihood of depression and more severe depression with higher grades. There were significant associations between increasing MIDAS grade and an increasing proportion of individuals who had consulted a doctor within the past year, lower use of over-the-counter medication, and greater use of prescription medications (p < 0.0001 for all three variables). Satisfaction with current therapy decreased significantly with increasing MIDAS grade, mirroring the frequency with which individuals achieved complete relief from headache. The MIDAS questionnaire was rated as easy to use by the vast majority of respondents, and ratings of its perceived value increased significantly as MIDAS grade increased.
Conclusions:
A low MIDAS score generally seems to indicate a low need for care, while individuals in MIDAS grades III and IV appear to have significant unmet medical care needs. The MIDAS questionnaire had increasingly perceived relevance as MIDAS grade increased, helped the majority of those in MIDAS grades III and IV to understand the impact of their headaches, and encouraged those with the greatest disability to seek medical care. The MIDAS questionnaire may facilitate communication between doctors and patients, and help physicians to identify those receiving inadequate medical care.
The seven-item Migraine Disability Assessment (MIDAS) questionnaire is a simple and useful tool for evaluating migraine-related disability. The goals of this study were: (1) to test the reliability and validity of the Taiwan version of the MIDAS (MIDAS-T) questionnaire, and (2) to measure the impact of migraine among Taiwanese patients in a headache clinic.
Consecutive migraine patients, aged 20-50 years, visiting the headache clinic at the Taipei Veterans General Hospital were invited to participate in the study. They completed the MIDAS-T and a form, which collected headache-related information including characteristics and impact on their lives. Of them, about 30 patients were randomly invited to repeat the MIDAS-T 3 weeks later.
A total of 281 migraine patients (M/F, 63/218; mean age, 35.27 +/- 8.21 years) participated in the study. Of them, 31 completed the MIDAS-T again 3 weeks later. MIDAS-T showed acceptable internal consistency (Cronbach alpha = 0.79), test-retest reliability (r = 0.67) and criterion validity (r = 0.37 for question A [headache frequency] and r = 0.34 for question B [headache intensity], p < 0.001). The mean score of migraine patients on MIDAS-T was 34.21 +/- 45.90, ranging from 0 to 265. MIDAS grade I (score 0-5) was found in 22% of patients, grade II (6-10) in 15%, grade III (11-20) in 17%, and grade IV (>or=21) in 46%.
This study supports the reliability and validity of MIDAS-T for use in Taiwanese patients. Almost half of the migraine patients were classified as having severe disability (grade IV).
SYNOPSIS
The authors probed the extent and clinical features of migraine through a community survey in the Bangkokslum. A total population of 540 individuals of both sexes were randomly selected from available subjects. They were interviewed using questionnaires. The response rate was 100%. The prevalence of migraine in the previous year in 135 men and 405 women was 10.4% and 35.3% respectively. The overall prevalence of migraine in this community was 29.1%. In both sexes, the prevalence declined with increasing age and in women, the effect of age was significant (p<.005). The clinical features of migraine (age of onset, headache profile, neurological symptoms, severity and frequency of headache, familial history, precipitating factors and medications for headache) were analyzed. We concluded that migraine is not uncommon in a low socioeconomic group in Thailand, and that this type of headache is a burden to patients and may have some economic effect. Thus, strategy in prevention and control of migraine should be critically considered.
Various guidelines recommend different strategies for selecting and sequencing acute treatments for migraine. In step care, treatment is escalated after first-line medications fail. In stratified care, initial treatment is based on measurement of the severity of illness or other factors. These strategies for migraine have not been rigorously evaluated.
To compare the clinical benefits of 3 strategies: stratified care, step care within attacks, and step care across attacks, among patients with migraine.
Randomized, controlled, parallel-group clinical trial conducted by the Disability in Strategies Study group from December 1997 to March 1999 in 88 clinical centers in 13 countries.
A total of 835 adult migraine patients with a Migraine Disability Assessment Scale (MIDAS) grade of II, III, or IV were analyzed as the efficacy population; the safety analysis included 930 patients.
Patients were randomly assigned to receive (1) stratified care (n = 279), in which patients with MIDAS grade II treated up to 6 attacks with aspirin, 800 to 1000 mg, plus metoclopramide, 10 mg, and patients with MIDAS grade III and IV treated up to 6 attacks with zolmitriptan, 2.5 mg; (2) step care across attacks (n = 271), in which initial treatment was with aspirin, 800 to 1000 mg, plus metoclopramide, 10 mg. Patients not responding in at least 2 of the first 3 attacks switched to zolmitriptan, 2.5 mg, to treat the remaining 3 attacks; and (3) step care within attacks (n = 285), in which initial treatment for all attacks was with aspirin, 800 to 1000 mg, plus metoclopramide, 20 mg. Patients not responding to treatment after 2 hours in each attack escalated treatment to zolmitriptan, 2.5 mg.
Headache response, achieved if pain intensity was reduced from severe or moderate at baseline to mild or no pain at 2 hours; and disability time per treated attack at 4 hours for all 6 attacks, compared among the 3 groups.
Headache response at 2 hours was significantly greater across 6 attacks in the stratified care treatment group (52.7%) than in either the step care across attacks group (40.6%; P<.001) or the step care within attacks group (36.4%; P<.001). Disability time (6 attacks) was significantly lower in the stratified care group (mean area under the curve [AUC], 185.0 mm. h) than in the step care across attacks group (mean AUC, 209.4 mm. h; P<.001) or the step care within attacks group (mean AUC, 199.7 mm. h; P<.001). The incidence of adverse events was higher in the stratified care group (321 events) vs both step care groups (159 events in across-attack group; 217 in within-attack group), although most events were of mild-to-moderate intensity.
Our results indicate that as a treatment strategy, stratified care provides significantly better clinical outcomes than step care strategies within or across attacks as measured by headache response and disability time. JAMA. 2000;284:2599-2605.
Migraine is not always well managed in clinical practice, often being under-diagnosed and under-treated. As a result, many sufferers never consult a physician or lapse from care after physician contact. Although most migraine care is provided by general practitioners, others, including specialists, emergency room physicians, pharmacists, and alternative practitioners, may also be involved. A method of standardizing clinical information about migraine is essential for coordinated, logical, and systematic care. The impact of migraine on the patient is an important clinical parameter but one that is seldom inquired about, perhaps because it exhibits such marked variability among and within individuals. Headache-related disability can be an objective and measurable index of this impact. The Migraine Disability Assessment (MIDAS) Questionnaire is a simple and validated instrument with potential for use in clinical practice, research, and public health. It can improve communication between patients and health-care professionals regarding the impact of migraine which, in turn, allows tailoring of the intensity of treatment to the severity of the illness. Changes in the MIDAS score may serve as an end point in assessing treatment efficacy. In populations, MIDAS scores may indicate the burden of migraine in the community and spark public health initiatives to improve management.
We evaluated the agreement between Migraine Disability Assessment (MIDAS) scores and independent physician judgments about pain, disability, and treatment needs based on patient medical histories.
The MIDAS questionnaire measures headache-related disability as lost time due to headache from paid work or school, household work, and nonwork activities.
Twelve histories from patients with migraine were presented to 49 primary and specialty care physicians unaware of the MIDAS scores. Physicians graded each patient for pain level (mild, moderate, or severe), level of disability (none, mild, moderate, or severe), and need for medical care (from 0 [lowest] to 100 [highest]). Physicians also identified MIDAS scores they associated with different degrees of disability and with the urgency to prescribe an effective treatment during the first consultation.
The physicians' perceptions of the need for medical care based on medical histories correlated with the MIDAS score (r =.69). Estimates of pain and disability by physicians were directly correlated with increasing MIDAS scores. Using the physicians' clinical judgments, the overall MIDAS score was categorized into four grades of increasing severity.
Scores on the MIDAS are highly correlated with physician judgments regarding patients' pain, disability, and need for medical care. These findings support the potential utility of the MIDAS questionnaire in clinical practice.
The migraine disability assessment questionnaire (MIDAS) is a recently developed, validated questionnaire for assessing the
impact of migraine on individual patients. We carried out a pilot study to assess the stability and reliability of a preliminary
Italian version of MIDAS, based on the original 6-item version. One hundred four patients with migraine without aura completed
the MIDAS form during a session with a neurologist and again 21 days later. Eighhty-six patients (83%) returned the second
form. Pearson's (r = 0.8) and Spearman's (r = 0.7) tests showed a good test-retest reliability for the scores obtained at
first and second compilations. In the majority of patients, the disability grade was stable after 21 days (Wilcoxon signed
rank test p > 0.05). Our preliminary adaptation of the MIDAS questionnaire is satisfactorily stable and highly reliable, preparing the
way for definitive Italian version.
The aim of this study is to assess the comprehensibility, internal consistency, patient-physician reliability, test-retest reliability, and validity of Turkish version of Migraine Disability Assessment (MIDAS) questionnaire in patients with headache.
MIDAS questionnaire has been developed by Stewart et al and shown to be reliable and valid to determine the degree of disability caused by migraine.
This study was designed as a national multicenter study to demonstrate the reliability and validity of Turkish version of MIDAS questionnaire. Patients applying to 17 Neurology Clinics in Turkey were evaluated at the baseline (visit 1), week 4 (visit 2), and week 12 (visit 3) visits in terms of disease severity and comprehensibility, internal consistency, test-retest reliability, and validity of MIDAS. Since the severity of the disease has been found to change significantly at visit 2 compared to visit 1, test-retest reliability was assessed using the MIDAS scores of a subgroup of patients whose disease severity remained unchanged (up to +/-3 days difference in the number of days with headache between visits 1 and 2).
A total of 306 patients (86.2% female, mean age: 35.0 +/- 9.8 years) were enrolled into the study. A total of 65.7%, 77.5%, 82.0% of patients reported that "they had fully understood the MIDAS questionnaire" in visits 1, 2, and 3, respectively. A highly positive correlation was found between physician and patient and the applied total MIDAS scores in all three visits (Spearman correlation coefficients were R= 0.87, 0.83, and 0.90, respectively, P <.001). Internal consistency of MIDAS was assessed using Cronbach's alpha and was found at acceptable (>0.7) or excellent (>0.8) levels in both patient and physician applied MIDAS scores, respectively. Total MIDAS score showed good test-retest reliability (R= 0.68). Both the number of days with headache and the total MIDAS scores were positively correlated at all visits with correlation coefficients between 0.47 and 0.63. There was also a moderate degree of correlation (R= 0.54) between the total MIDAS score at week 12 and the number of days with headache at visit 2 + visit 3, which quantify headache-related disability over a 3-month period similar to MIDAS questionnaire.
These findings demonstrated that the Turkish translation is equivalent to the English version of MIDAS in terms of internal consistency, test-retest reliability, and validity. Physicians can reliably use the Turkish translation of the MIDAS questionnaire in defining the severity of illness and its treatment strategy when applied as a self-administered report by migraine patients themselves.