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How Well Do Headache Patients Remember? A Comparison of Self-Report Measures of Headache Frequency and Severity in Patients with Migraine
Jeff A. McKenzie, BA; Michael Cutrer, MD
Posted: June 2009  
Headache  2009;49(5):669-672

Objective:   To compare patient recall of migraine headache frequency and severity over 4 weeks prior to a return visit as reported in an interval questionnaire vs. a daily diary.

Background:   Many therapeutic decisions in the management of migraine patients are based on patient recall of response to treatment. As consistent completion of a daily headache diary is problematic, we have assessed the reliability of patient recall in a 1-time questionnaire.

Methods:   Headache frequency and average severity (0 to 3 point scale) were reported in an interval questionnaire by 209 patients who had also maintained a daily diary over the same three-week period.

Results:   Headache frequency over the previous 4 weeks as reported in internal questionnaires was not different from that documented in diaries, P=.056. However, reported average headache severity on a 0 to 3 scale as reported in the questionnaire was worse than that documented in the diaries, P <.001.

Conclusions:   In the management of individual patients, the daily diary is still preferable when available. Aggregate assessment of headache frequency in groups of patients based on recall of the prior 4 weeks is equally as reliable as a diary. Headache severity reported in questionnaires tends to be greater than that documented in daily diaries and may be less reliable.