Health professionals
Guidelines and classifications to assist with diagnosis and management
The guidelines, classifications and measures covered below may be helpful to healthcare professionals in the diagnosis and management of migraine and other headaches.
BASH Management Guidelines
The British Association for the Study of Headache (BASH) is the United Kingdom national society member of the International Headache Society (IHS) and the European Headache Federation (EHF). Its membership is open to all healthcare professionals with an interest in headache. BASH works closely with The Migraine Trust to support the development of headache service delivery.
The Association produces the BASH Guidelines for the diagnosis and management of migraine, tension-type, cluster and medication-overuse headache. The BASH Guidelines are intended for use by all healthcare professionals and have been written by headache specialists who base the Guidelines on existing evidence and clinical experience. The latest edition of the Guidelines is available to download from the BASH website.
BASH Guidance for Primary Care on who to image when brain tumour is suspected
BASH have issued guidance for GPs on who to image when brain tumour is suspected, which was published in the British Journal of General Practice 2008;58: 880-885. This guidance is accessible via the BASH website.
The International Classification of Headache Disorders, 2nd edition (ICHD-II)
The International Headache Society (IHS) describe the International Classification of Headache Disorders, 2nd edition (ICHD-II) as the “single most important document to read for doctors taking an interest in the diagnosis and management of headache patients”.
All headache disorders are classified in the ICHD-II into major groups and each group is then subdivided one, two or three times into headache types, subtypes and subforms. The practising family physician may only need to diagnose at the first level in order to select acute treatment. However, when there is a problem of differential diagnosis it becomes necessary to distinguish between one headache type and other disorders that may mimic it, and thus to code at the second or third levels. Practising neurologists and headache specialists would normally diagnose the precise subform of a headache type at the third level.
Headache Impact Test
The Headache Impact Test (HIT) is a tool to measure the impact headaches have on a person's ability to function on the job, at school, at home and in social situations. The score a person gets shows the effect that headaches have on normal daily life and their ability to function.
HIT was developed by an international team of headache experts from neurology and primary care medicine in collaboration with psychometricians. You can find out more at www.headachetest.com
I-D Migraine Test
The I-D Migraine test is a simple 3-step test for patients. Lipton RB, Dodick D, Sadovsky R, al. e. A self-administered screener for migraine in primary care: the ID Migraine ™ validation study. Neurology 2003; 61:375-382
MIDAS, Migraine Disability Assessment Scale
The MIDAS (migraine disability assessment scale) was created to help measure the impact headaches have on a person’s life. It was developed by Richard B. Lipton, MD, Professor of Neurology, Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology, Johns Hopkins University, Baltimore, MD.
The American Headache Society has a tool for carried out the assessment at http://www.achenet.org/tools/migraine/index.asp.