Signs and Evidence

Making clinical sense of scientific data

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Migraine

Calculated pretest-probability: 21.45 %
Relevant inclusion criteria: Primary headache Calculate probabilities!

Clinical signs

Nausea
 Positive likelihood ratio
19.20 ( Smetana GW et al. )
(average) 19.20
Negative likelihood ratio
0.20 ( Smetana GW et al. )
(average) 0.2
Photophobia
 Positive likelihood ratio
5.80 ( Smetana GW et al. )
(average) 5.80
Negative likelihood ratio
0.25 ( Smetana GW et al. )
(average) 0.25
Phonophobia
 Positive likelihood ratio
5.20 ( Smetana GW et al. )
(average) 5.20
Negative likelihood ratio
0.38 ( Smetana GW et al. )
(average) 0.38
Exacerbation by physical activity
 Positive likelihood ratio
3.70 ( Smetana GW et al. )
(average) 3.70
Negative likelihood ratio
0.24 ( Smetana GW et al. )
(average) 0.24
Unilateral pain
 Positive likelihood ratio
3.70 ( Smetana GW et al. )
(average) 3.70
Negative likelihood ratio
0.43 ( Smetana GW et al. )
(average) 0.43
Throbbing or pulsating pain
 Positive likelihood ratio
2.90 ( Smetana GW et al. )
(average) 2.90
Negative likelihood ratio
0.36 ( Smetana GW et al. )
(average) 0.36
Lacrimation during headache
 Positive likelihood ratio
0.04 ( Uluduz D et al. )
(average) 0.04
Negative likelihood ratio
2.11 ( Uluduz D et al. )
(average) 2.11

Sources used:

1.Smetana GW et al. The Diagnostic Value of Historical Features in Primary Headache SyndromesA Comprehensive Review. Arch Intern Med. 2000;160(18):2729-2737
2.Uluduz D et al. Cranial autonomic features in migraine and migrainous features in cluster headache. Arch Neuropsychiatr 2016; 53
3.Sedlic M et al. Epidemiology of Primary Headaches Among 1,876 Adolescents: A Cross-Sectional Survey. Pain Medicine 2016; 17: 353–359
4.Kim BK et al. Prevalence and Impact of Migraine and Tension-Type Headache in Korea. J Clin Neurol. 2012 Sep; 8(3): 204–211
5.Stovner LJ et al. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain (2010) 11:289–299