Clinical utility of an instrument assessing migraine disability: The Migraine Disability Assessment (MIDAS) questionnaire

Objective.-We evaluated the agreement between Migraine Disability Assessmen t (MIDAS) scores and independent physician judgments about pain, disability , and treatment needs based on patient medical histories. Background.-The MIDAS questionnaire measures headache-related disability as lost time due to headache from paid work or school, household work, and no nwork activities. Methods.-Twelve histories from patients with migraine were presented to 49 primary and specialty care physicians unaware of the MIDAS scores. Physicia ns graded each patient for pain level (mild, moderate, or severe), level of disability (none, mild, moderate, or severe), and need for medical care (f rom 0 [lowest] to 100 [highest]). Physicians also identified MIDAS scores t hey associated with different degrees of disability and with the urgency to prescribe an effective treatment during the first consultation. Results.-The physicians' perceptions of the need for medical care based on medical histories correlated with the MIDAS score (r=.69). Estimates of pai n and disability by physicians were directly correlated with increasing MID AS scores. Using the physicians' clinical judgments, the overall MIDAS scor e was categorized into four grades of increasing severity. Conclusions.-Scores on the MIDAS are highly correlated with physician judgm ents regarding patients' pain, disability, and need for medical care. These findings support the potential utility of the MIDAS questionnaire in clini cal practice.