Using computer adaptive testing to improve migraine outcomes

Erin M. Buchanan

2021-12-20

Outline

Migraine Background
Previous Assessment Work
- Themes
- Traditional EFA Development
Current Goals
- Phone App Tracker
- Computer Adaptive Assessment
- Multigroup or DIF analysis

What is a headache?

Head pain that is unpleasant, ranging from mild to severe
Pressure and aching
Triggers include stress, anxiety, sinus
Nearly everyone experiences these

What is a migraine?

Often characterized as an “attack”
Moderate to severe pain
Comorbid with visual disturbances, nausea, vomiting, sensitivity to light/sound/smell, auras
~12% of the population experiences these

Infographic

Fast facts

3rd most prevalent illness in the world
A woman’s illness
Often 1-2 attacks per month, others are chronic with 15+ per month
Serious impacts on work, family, and daily life

Previous work

We developed the Functional Assessment of Migraine Scale to measure response to treatment across a wide variety of patient concerns
- First, we established factors that were indicated as most important to patients when appraising the efficacy of treatment
- Second, we developed a patient reported outcome measure to evaluate headache meaningful response to headache treatment regimens
Why?
- Migraine Disability Assessment (MIDAS): 5 items measuring loss of productivity across work and social/family
- Headache Impact Test (HIT-6): 6 items measuring lost work time, pain severity, fatigue

What is important?

Two Main Results:
- Rating of importance for our preselected themes
- Thematic Analysis of open ended responses

Ratings

Thematic analysis

Traditional EFA Development

Finalized Scale

The FAMS is a set of scales:
- Research (18 items)
- Clinical (9 items)
- Supplemental (9 items)
Psychometrics appear to support reliability, validity, and predictive usefulness.

Current Goals

Implement CAT

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Implement CAT

Next steps

Collect more data!
Separate models for episodic and chronic patients indicate similar scale functioning for each subset of patients
- A small amount of evidence that these may be equivalent
- Ensure each population represented in data
Update based on feedback

Thanks for listening!

Migraine is a multi-faceted illness with many factors to consider!
Thanks to Clinvest Research, Harrisburg University, and the National Headache Foundation for supporting this research.
Questions?