Development and validation of the ID-EC - the ITALIAN version of the identify chronic migraine

Simona Sacco, Silvia Benemei, Sabina Cevoli, Gianluca Coppola, Pietro Cortelli, Francesco De Cesaris, Roberto De Icco, Cristiano Maria De Marco, Cherubino Di Lorenzo, Pierangelo Geppetti, Alessia Manni, Andrea Negro, Raffaele Ornello, Giulia Pierangeli, Francesco Pierelli, Lanfranco Pellesi, Luigi Alberto Pini, Francesca Pistoia, Maria Pia Prudenzano, Antonio RussoGrazia Sances, Valentina Taranta, Cristina Tassorelli, Gioacchino Tedeschi, Maria Trojano, Paolo Martelletti

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Case-finding tools, such as the Identify Chronic Migraine (ID-CM) questionnaire, can improve detection of CM and alleviate its significant societal burden. We aimed to develop and validate the Italian version of the ID-CM (ID-EC) in paper and as a smart app version in a headache clinic-based setting.

METHODS: The study investigators translated and adapted to the Italian language the original ID-CM questionnaire (ID-EC) and further implemented it as a smart app. The ID-EC was tested in its paper and electronic version in consecutive patients referring to 9 Italian tertiary headache centers for their first in-person visit. The scoring algorithm of the ID-EC paper version was applied by the study investigators (case-finding) and by patients (self-diagnosis), while the smart app provided to patients automatically the diagnosis. Diagnostic accuracy of the ID-EC was assessed by matching the questionnaire results with the interview-based diagnoses performed by the headache specialists during the visit according to the criteria of International Classification of Headache Disorders, III edition, beta version.

RESULTS: We enrolled 531 patients in the test of the paper version of ID-EC and 427 in the validation study of the smart app. According to the clinical diagnosis 209 patients had CM in the paper version study and 202 had CM in the smart app study. 79.5% of patients returned valid paper questionnaires, while 100% of patients returned valid and complete smart app questionnaires. The paper questionnaire had a 81.5% sensitivity and a 81.1% specificity for case-finding and a 30.7% sensitivity and 90.7% specificity for self-diagnosis, while the smart app had a 64.9% sensitivity and 90.2% specificity.

CONCLUSIONS: Our data suggest that the ID-EC, developed and validated in tertiary headache centers, is a valid case-finding tool for CM, with sensitivity and specificity values above 80% in paper form, while the ID-EC smart app is more useful to exclude CM diagnosis in case of a negative result. Further studies are warranted to assess the diagnostic accuracy of the ID-EC in general practice and population-based settings.

Original languageEnglish
Pages (from-to)15
JournalThe journal of headache and pain
Issue number1
Publication statusPublished - Feb 13 2019


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