Validity and reliability of the Migraine-Treatment Optimization Questionnaire

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.
• 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.