E-diary use in clinical headache practice: A prospective observational study

Area of Science:

• Neurology
• Digital Health
• Medical Informatics

Background:

• Migraine diagnosis and frequency tracking are crucial for effective patient management.
• Patient self-reported estimates of migraine frequency and medication use can be unreliable due to recall bias.
• Digital tools offer potential for more objective and accurate data collection in headache disorders.

Purpose of the Study:

• To evaluate the diagnostic utility of a self-developed E-diary for migraine.
• To compare the reliability of E-diary-based migraine frequency data against patient self-estimates.
• To assess the accuracy of an E-diary combined with E-questionnaires for migraine diagnosis.

Main Methods:

• A self-developed E-diary with automated algorithms was used to differentiate headache and migraine days.
• The diagnostic performance of the E-diary, alone and with E-questionnaires, was compared to physician diagnosis (gold standard).
• Migraine patients' self-estimated frequencies were compared with E-diary data.

Main Results:

• The E-diary combined with an E-headache questionnaire showed 98% sensitivity and 17% specificity for migraine screening.
• Adding an E-migraine questionnaire improved diagnostic accuracy to 79% sensitivity and 69% specificity.
• Significant differences were observed between self-estimated and E-diary-based frequencies for migraine days, non-migraine headache days, and acute medication use.

Conclusions:

• The E-diary effectively aids in diagnosing migraine by differentiating headache and migraine days.
• E-diaries provide more reliable data on migraine frequency and medication intake compared to patient recall.
• Integrating E-diaries into telemedicine platforms can enhance the management of headache disorders.