A headache clinic-based approach to field trials of the International Headache Society criteria

Criteria for the diagnosis of headache disorders have recently been developed but require empirical validation. We present an approach to the evaluation of headache criteria in a headache clinic: define the group of headache sufferers to be studied, obtain data used in establishing the diagnosis, apply the diagnostic criteria and assess their usefulness. In applying this method to a group of patients with chronic daily headache, we found that approximately one-third would not fit the current criteria for chronic tension-type headache. We conclude that empiric validation of headache criteria based on subjective data is a complex and iterative process. Operational criteria for headache diagnosis to be used by primary care physicians should be validated in that setting and ideally should be relatively simple.