What’s a migraine day? Towards a consensus definition for clinical care and research – a Delphi panel-based study
Year: 2026
Type: article
Abstract: BACKGROUND: Although guidelines for controlled trials have proposed a definition for a migraine day, substantial variability remains across clinical trials, highlighting the need for a universally adopted definition. METHODS: Through three survey rounds using an eDelphi method, a panel of 18 headache experts evaluated clinical scenarios to achieve consensus on a standardized definition of a migraine day. The first two rounds provided clear-cut cases with the question whether a clinical scenario should be labelled as a migraine day and the third round proposed a migraine day definition. Consensus was predefined at 70% agreement. RESULTS: A consensus was reached on a proposed definition of a migraine day across three distinct situations: (1) without acute treatment, (2) with acute treatment, and (3) in the presence of aura. If untreated, a headache day can be labelled as a (probable) migraine day when the following criteria are met: headache lasting ≥ 4 h having at least two out of four headache characteristics, regardless of the presence of any associated symptom or at least one out of four headache characteristics combined with one associated symptom. If treated, a headache day can be labelled as a migraine day when the following criterion is met: lasting ≥ 30 min, regardless of drug (class) taken, the presence of any headache characteristic or associated symptom. In the presence of aura, a migraine day can be defined as any calendar day on which the following criterion is met: an aura, fulfilling the ICHD-3 criteria for migraine with aura, is experienced regardless of the presence of headache. CONCLUSIONS: We suggest the Classification Committee considers this eDelphi survey based consensus definition as a possible definition both for clinical trials and clinical care in the new edition of the International Classification of Headache Disorders. CLINICAL TRIAL NUMBER: Not applicable.
Source: The Journal of Headache and Pain
Authors: Luna De Loose, Koen Paemeleire, Christina I. Deligianni, Christian Lampl, Derya Uluduz, Erling Tronvik, Gianluca Coppola, Henrik Schytz, Jean Schoenen, Margarita Sanchez del Rio, Paolo Martelletti, Patricia Pozo-Rosich, Raquel Gil-Gouveia, Kristina Ryliskiene, Simona Sacco, Esme Ekizoglu, Igor Petrušić, Rolf Fronczek, Phil Holland, Uwe Reuter, Peter J. Goadsby, Antoinette MaassenVanDenBrink, Jan Versijpt
Institutions: Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Ghent University Hospital, National and Kapodistrian University of Athens, Eginition Hospital, Athens Naval & Veterans Hospital, Convent Hospital of the Brothers of Saint John of God, Istanbul University-Cerrahpaşa, Atlas Üniversitesi, Istanbul University, Norwegian University of Science and Technology, St Olav's University Hospital, Sapienza University of Rome, Copenhagen University Hospital, Rigshospitalet, University of Liège, Clinica Universidad de Navarra, Unitelma Sapienza University, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universidade Católica Portuguesa, Hospital da Luz, Vilnius University, University of L'Aquila, University of Belgrade, Leiden University, Leiden University Medical Center, Stichting Epilepsie Instellingen Nederland, King's College London, University Hospital Bonn, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charité - Universitätsmedizin Berlin, National Institute for Health and Care Research, King Abdullah University of Science and Technology, Erasmus MC
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,990
OpenAlex ID: W7160719871