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Cited by 1,376Migraine and Headache StudiesHealth Education and ValidationSurvey Methodology and Nonresponse

A six-item short-form survey for measuring headache impact: The HIT-6™

Kosinski, M., Bayliss, M.S., Bjorner, J.B., Ware, J.E., Garber, W.H., Batenhorst, A., Cady, R., Dahlöf, C.G.H. +2 more·2003·Quality of Life Research
DOI 10.1023/a:1026119331193
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Abstract

Background Migraine and other severe headaches can cause suffering and reduce functioning and productivity. Patients are the best source of information about such impact.Objective To develop a new short form (HIT-6) for assessing the impact of headaches that has broad content coverage but is brief as well as reliable and valid enough to use in screening and monitoring patients in clinical research and practice.Methods HIT-6 items were selected from an existing item pool of 54 items and from 35 items suggested by clinicians. Items were selected and modified based on content validity, item response theory (IRT) information functions, item internal consistency, distributions of scores, clinical validity, and linguistic analyses. The HIT-6 was evaluated in an Internet-based survey of headache sufferers (n = 1103) who were members of America Online (AOL). After 14 days, 540 participated in a follow-up survey.Results HIT-6 covers six content categories represented in widely used surveys of headache impact. Internal consistency, alternate forms, and test-retest reliability estimates of HIT-6 were 0.89, 0.90, and 0.80, respectively. Individual patient score confidence intervals (95%) of app. +/-5 were observed for 88% of all respondents. In tests of validity in discriminating across diagnostic and headache severity groups, relative validity (RV) coefficients of 0.82 and 1.00 were observed for HIT-6, in comparison with the Total Score. Patient-level classifications based in HIT-6 were accurate 88.7% of the time at the recommended cut-off score for a probability of migraine diagnosis. HIT-6 was responsive to self-reported changes in headache impact.Conclusions The IRT model estimated for a 'pool' of items from widely used measures of headache impact was useful in constructing an efficient, reliable, and valid 'static' short form (HIT-6) for use in screening and monitoring patient outcomes.

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Authors
Kosinski, M., Bayliss, M. S., Bjorner, J. B., Ware, J. E., Garber, W. H., Batenhorst, A., Cady, R., Dahlöf, C. G. H., Dowson, A., & Tepper, S.
Affiliations
  • TerraMetrics (United States) (US)
  • Tufts University (US)
  • Headache Care Center (US)
  • King's College Hospital (GB)
Corresponding author
Kosinski, M.
ORCID
Venue
Quality of Life Research
Publisher
Springer Science and Business Media LLC
Published
2003-12
Volume
12
Issue
8
Pages
963-974
ISSN
  • 0962-9343 (ISSN-L)
  • 1573-2649
DOI
10.1023/a:1026119331193
OpenAlex
W204766049
Cited by
1,376
References
24
Citations by year
2026: 123 · 2025: 128 · 2024: 119 · 2023: 123 · 2022: 124 · 2021: 116 · 2020: 115 · 2019: 67 · 2018: 41 · 2017: 62 · 2016: 38 · 2015: 52 · 2014: 39 · 2013: 31 · 2012: 39
FWCI
6.94
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Quality of Life Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
  • Social Sciences › Education › Health Education and Validation
  • Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
Keywords
HIT-6, headache impact, migraine, short-form questionnaire, item response theory, content validity, reliability statistics, validity, patient-reported outcomes, headache severity, questionnaire development
MeSH terms
Adult, Calibration, Headache, Humans, Psychometrics, Quality of Life, Surveys and Questionnaires, United States, Sickness Impact Profile, Internet

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