Are doctors accurate when diagnosing themselves with migraine? A study on migraine prevalence among doctors in a tertiary care hospital

DOI: https://doi.org/10.1007/s13760- 021- 01727- w

Abstract-Summary Different studies show a higher prevalence in neurologists.

There are few studies about its prevalence in doctors of other specialties, where

it could also be superior than in general population.

Our aim was to define migraine lifetime prevalence among doctors according to three parameters (previous diagnosis, self-diagnosis and positivity of a screen- ing test).

Participants who reported 5 or more headaches throughout their lives were con- sidered “headache sufferers” and were divided in different groups according to their position (specialists or trainees) and their specialty (medical, medical-surgical and surgical or specialties with no direct contact with the patient).

77% were “headache sufferers” Among all participants, migraine lifetime preva- lence according to diagnosis by another physician was 15.2%, self-diagnosis 38.2% and positivity of the MS-Q 20.3%; those categories were not mutually exclusive Greater but not statistically significant coexistence of self-diagnosis and positive MS-Q was seen in specialists compared to trainees and in medical specialties.

Migraine prevalence among doctors in a tertiary care hospital was higher than in

general population, according to all three parameters analyzed.

Extended: These findings could be useful for future prevalence studies and might also help the development of more accurate screening tools for migraine diagnosis in both general population and subgroups with a former knowledge of the disease.

Introduction Different studies have shown higher migraine prevalence in neurologists and head- ache specialists [516–518], which may be explained by a deeper knowledge on the disease that could help them reach a migraine self-diagnosis, without needing another doctor’s confirmation [519].

Those fewer studies that have evaluated migraine prevalence in other specialties, most of them focused on primary care doctors, have shown a similar prevalence to that of the general population [520–523].

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To the best of our knowledge, there are no studies that have compared migraine

prevalence in doctors from different specialties.

Thanks to their medical training and their familiarity with migraine, a higher prevalence could be expected in doctors responsible for the diagnosis and/or treat- ment of this disease, as observed in neurologists.

The main objective of our study was to estimate migraine prevalence in doctors of a tertiary hospital according to three parameters: previously diagnosed by another doctor (PD), self-diagnosis (SM) and positivity of the Spanish validated screening test, the Migraine Screen Questionnaire (positive MS-Q).

Methods The sample included doctors from different specialties working at that moment in the hospital.

We classified participants in groups according to their specialty and position (specialists and trainees) and we determined migraine prevalence in the general sample and in the different subgroups according to PD, SM and positive MS-Q. We also analyzed the coexistence of SM and positive MS-Q in the different subgroups. A descriptive analysis of the characteristics of both groups was performed: for the nominal variables, the sample size (N) and the percentage (%) per group were shown, and a χ2 test or the Fisher exact test was performed.

Model, variables that in the descriptive had shown a p ≤ 0.1 were included.

Results Of the 95 specialists participating in our study, 75 (78.9%) have had ≥5 headaches throughout their lives, as they are necessary to consider a migraine diagnosis accord- ing to ICHD-3 criteria [20].

When asked about the type of headache they thought they suffered, 83 partici-

pants answered migraine (prevalence according to SM 83/217 (38.2%)).

According to specialties, 26/119 (21.8%) of the participants in the group of “medical specialties” presented SM and positive MS-Q, while this proportion was 5/30 (16.7%) in the participants of the group “surgical and medical-surgical” and 6/18 (3.3%) in group of specialists with “no direct treat with patients”.

Regarding work position, 18/82 (21.9%) of the trainees and 29/75 (38.7%) of the specialists had both SM and positive MS-Q. However, these differences observed in SM and MS-Q coexistence between specialty groups and work position did not reach statistical significance (p = 0.086 and p = 0.083, respectively).

Discussion According to our work, 58.3% of the neurologists reported a self-diagnosis of migraine while only 20.8% had a positive MS-Q. Both percentages are within the range of migraine prevalence in neurologists in different studies (27.6% and 71%) [517–519].

Our study also showed a higher prevalence of migraine in specialists than in trainees according to both SM and positive MS-Q. Not only age and time with the disease could have affected the difference in migraine prevalence, but also working experience could be reflected in these results.

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Ours is the first study that has tried to estimate migraine prevalence in doctors of different specialties and working position, regarding three parameters (previous diagnosis of migraine, self-diagnosis or positivity of MS-Q).

Acknowledgement A machine generated summary based on the work of Muro, Ines; Gago-Veiga, Ana Beatriz; Vivancos, Jose; Vega-Piris, Lorena; Ruiz, Miguel; Quintas, Sonia. 2021 in Acta Neurologica Belgica.

Shortcomings and missed potentials in the management of migraine patients—experiences from a specialized tertiary care center