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Validity and reliability of the Migraine-Treatment Optimization Questionnaire.

R B Lipton¹, K Kolodner, M E Bigal

¹Department of Neurology, Albert Einstein College of Medicine, New York, NY 10461, USA. rlipton@aecom.yu.edu

Cephalalgia : an International Journal of Headache

|February 26, 2009

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A new patient-rated Migraine Treatment Optimization Questionnaire (M-TOQ) shows promise for assessing migraine treatment effectiveness in primary care. Both a 15-item (M-TOQ-15) and a 5-item (M-TOQ-5) version demonstrated good reliability and validity.

Area of Science:

Neurology
Clinical Research
Patient-Reported Outcomes

Background:

Migraine treatment optimization requires reliable patient-reported outcome measures.
Existing tools may not fully capture patient-perceived treatment benefits in primary care settings.

Purpose of the Study:

To establish the validity and reliability of a patient-rated Migraine Treatment Optimization Questionnaire (M-TOQ) for use in primary care.
To develop and assess two versions of the M-TOQ: a 15-item (M-TOQ-15) for research and a 5-item (M-TOQ-5) for primary care.

Main Methods:

Adult patients meeting International Classification of Headache Disorders criteria for migraine completed the candidate M-TOQ and established validity/reliability questionnaires (MIDAS, HIT-6, MSQoL).
Factor analysis identified five treatment optimization domains: functioning, rapid relief, consistency, risk of recurrence, and tolerability.

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Internal consistency (Cronbach's alpha) and convergent validity (correlations with other scales) were evaluated.

Main Results:

The M-TOQ-15 demonstrated strong internal consistency (Cronbach's alpha = 0.85) and good correlations with MIDAS, HIT-6, and MSQoL (r = 0.33-0.44).
The M-TOQ-5 also showed acceptable internal consistency (Cronbach's alpha = 0.66) and good correlations with the other scales (r = 0.33-0.41).
Five key domains of treatment optimization were identified with good reliability (Cronbach's alpha 0.70-0.84).

Conclusions:

The M-TOQ, in both 15-item and 5-item formats, appears to be a valid and reliable measure for assessing migraine treatment optimization.
The M-TOQ-15 shows utility for research applications, while the M-TOQ-5 may be suitable for primary care settings.
Further validation studies are recommended to confirm the utility of the M-TOQ in diverse research and clinical contexts.