PedMIDAS Tool for Assessing Migraine Disability

PedMIDAS was developed to assess migraine disability in pediatric and adolescent patients. It has been tested and validated for ages 4 to 18 and mirrors the use of the adult MIDAS that Lipton and Stewart developed for adults age 20 to 50. It is intended to be self-administered by the patient and their parent. It can be completed in collaboration, but the answers need to be confirmed with the patient. Its implementation and design are straightforward.

About the PedMIDAS Questions

The first three PedMIDAS questions relate to the impact of headache on school performance. Caution needs to be taken to minimize duplication of days (i.e., don’t count a half day missed both as a full day missed and a half day missed). This is stated in the directions and in the questions, but occasionally needs to be checked.

The fourth question concerns disability at home. Occasionally it needs to be clarified that it only counts as a missed day due to headaches if the activity was expected on that day (i.e., homework was not completed due to headaches for the day, not just delayed OR the chores aren’t done for other reasons). This usually is not a problem for teenagers to understand and has lesser impact on the pediatric group. The final two questions relate to social / sports function and rarely are a problem for the children to answer − they easily remember the days they missed out on fun events.

The score is a simple composite of the total of six questions. If a range is provided, use the high end of the range or ask the family to provide a single number − both methods show equal validity. If the answer is blank or is a phrase (i.e., “few” or “couple”), they need to be asked to provide a number. This is an example of the importance of reviewing the questionnaire with the patient. The frequency and severity questions are not scored, but obtained for clinical reference.

PedMIDAS Grading Scale

The PedMIDAS grading scale is as follows: