ASSESSMENT OF INTERNATIONAL-HEADACHE-SOCIETY DIAGNOSTIC-CRITERIA - A RELIABILITY STUDY

In 1988 the International Headache Society (IHS) introduced new diagno stic criteria for headaches and craniofacial pain. Since headaches can be diagnosed solely on the basis of information provided by the patie nt, it is essential that the criteria are reproducible and consistent. Two neurologists evaluated the clinical records of 100 consecutive ou tpatients and transferred the data on headache and associated phenomen a to a form designed to reflect the IHS criteria. Interobserver concor dance (kappa statistics) in the application of the diagnostic criteria of primary headaches was: (i) ''perfect'' to ''substantial'' for the first IHS digit, being kappa = 1.0 for cluster headache and paroxysmal hemicrania; kappa = 0.88 for migraine; kappa = 0.75 for tension-type headache; (ii) ''almost perfect'' to ''substantial'' for the second di git (kappa = 0.94 for cluster headache; kappa = 0.90 for migraine with aura; kappa = 0.81 for episodic tension-type headache; kappa = 0.78 f or migraine without aura; kappa = 0.71 for chronic tension-type headac he; kappa = 0.66 for cluster headache-like disorder not fulfilling the criteria; (iii) ''moderate'' for migrainous disorder (kappa = 0.48) a nd headache of the tension-type (kappa = 0.43) not fulfilling the crit eria. These results show that the IHS diagnostic criteria are satisfac torily applicable to high quality medical records abstracted by experi enced neurologists.