Reviewer's report
Title:Agreement of Self-Reported Physician Diagnosis of Migraine with
International Classification of Headache Disorders-II Migraine Diagnostic Criteria
in a Cross-sectional Study of Pregnant Women
Version: 1Date:26 September 2013
Reviewer: Paola Torelli
Reviewer's report:
In a group of 500 pregnant women, the authors assessed the concordance
between self-reported physician diagnosis of migraine and the diagnosis of
migraine established considering the women’s answers to a structured
questionnaire based on the diagnostic criteria of the International Classification of
Headache Disorders, 2nd edition (ICHD-II).
The greatest limitation of the study is represented by the fact that the
self-reported physician diagnosis of migraine was not compared against a Gold
Standard using a face-to-face interview, but against a questionnaire-based
diagnosis.
Major Compulsory Revisions
1. Concordance should be determined also by estimating the value of Cohen’s
kappa coefficient (Cohen J. A coefficient of agreement for nominal scales.
Education Psychol Measure 1960; 20:37-46.)
2.The diagnostic section of the questionnaire should be attached to the paper.
3. Background
Page 4: The last sentence of the Background section should be rewritten so as to
explicitly state the primary objective of the study.
4. Methods
4.1 Page 4: Indicate whether the 500 women in the initial sample were
consecutive referrals at the Swedish Medical Center or whether some kind of
selection was applied.
4.2 Page 4: Specify the tools that were used to evaluate the disability associated
with headaches experienced before and during pregnancy.
4.3 Page 4: Indicate whether the questionnaire used to establish the diagnosis of
migraine was previously validated and, in the affirmative, specify (a) the Gold
Standard it was tested against; (b) the testing modality; and (c) its sensitivity and
specificity values.
4.4 Page 4: Indicate whether the questionnaire was administered by a physician.
4.5 Page 4: Indicate how the presence of a previous physician diagnosis of
migraine was determined in the women under study. Was there any specific
question in the questionnaire? Was it necessary that the physician diagnosis of
migraine be proved by medical records or was it enough that the diagnosis
information be simply reported?
5. Results:
Page 7: The sentence “We confirmed self-reported migraine in 81.6% of women
when applying the ICHD-II criteria for migraine (63.1%) and probable migraine
(18.5%)” should be changed specifying “ […] criteria for definitive migraine
(63.1%) […]”.
6. Discussion:
Page 7: The authors state “Our study finding of a high prevalence (29.8%) […] is
consistent with prior literature […]” and to support their statement they mention
the 1-year prevalence found in the American Migraine Prevalence and
Prevention study. It would be more correct to have data compared considering
the studies that evaluated the lifetime prevalence of migraine, because it seems
that in this women cohort the past/1-year prevalence was not investigated.
7. Conclusions:
Page 9-10: The sentence “Our findings demonstrate the feasibility of using
questionnaire-based migraine assessment according to full ICHDII criteria in
epidemiological studies of pregnant women” is not correct. The validity of the
questionnaire was not studied in this population. It can only be stated that there
was a certain degree of agreement, which should be quantified, between
self-reported physician diagnosis of migraine and the diagnosis of migraine
based on the questionnaire according to the ICHD-II criteria.
Minor Essential Revisions
Throughout the text, please replace ICD-II with ICHD-II.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests