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Development and evaluation of a screening tool to aid the diagnosis of a cluster headache

Buture, Alina; Boland, Jason W.; Dikomitis, Lisa; Huang, Chao; Ahmed, Fayyaz


Alina Buture

Jason W. Boland

Lisa Dikomitis

Fayyaz Ahmed


Cluster headache (CH), a severe primary headache, is often misdiagnosed and mismanaged. The aim of this study was to develop and evaluate a screening tool to aid the diagnosis of CH. We developed a novel 12-item screening tool. This was comprised of four components: (1) images depicting headache pain; (2) pain descriptors; (3) key questions that could differentiate between CH and migraine; and (4) a visual analogue pain scale. The total possible questionnaire score ranged from 3-32. Patients with CH and migraines (control group) were recruited prospectively from a headache centre in the North of England, UK. Two-hundred and ninety-six patients were included in the study: 81 CH patients, 36 of which suffer with episodic CH and 45 with chronic CH; 215 migraine patients, 92 of which suffer with episodic migraine and 123 with chronic migraine. The mean questionnaire score was higher in CH patients versus migraine patients (28.4 versus 19.5). At a cut-off score of >25 out of 32, the screening tool had a sensitivity of 86.4% and a specificity of 92.0% in differentiating between CH and migraine. The screening tool could be a useful instrument to aid the diagnosis of a CH. The images depicting headache pain do not clearly discriminate between CH and migraine.


Buture, A., Boland, J. W., Dikomitis, L., Huang, C., & Ahmed, F. (2020). Development and evaluation of a screening tool to aid the diagnosis of a cluster headache. Brain Sciences, 10(2), Article 77.

Journal Article Type Article
Acceptance Date Jan 30, 2020
Online Publication Date Feb 1, 2020
Publication Date 2020-02
Deposit Date Apr 4, 2022
Publicly Available Date Oct 27, 2022
Journal Brain Sciences
Electronic ISSN 2076-3425
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 10
Issue 2
Article Number 77
Keywords Migraine; Images; Drawings; Questionnaire; Sensitivity; Specificity; Survey; Intervention development
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Copyright Statement
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (

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