[5] The instrument consists of 6 questions addressing school absence, poor functioning during school, and disruption of home and social/recreational activities over a 3-month recall period. In the clinical setting, the PedMIDAS can be helpful in assessing a patient’s migraine burden and response to therapy. Some researchers advocate its use as an outcome measure in clinical trials.[5] While the PedMIDAS is comparable to the adult Migraine

Disability Assessment (MIDAS),[6] differences exist between school-aged children and adults. While most adults have year-round work and/or household duties, most school-aged children have a prolonged interruption in school attendance each summer. Rapamycin cell line Fifty percent of the PedMIDAS questions address school-related disability, so disability scoring should be systematically higher on school days than on non-school days. Accordingly, scores from the 3-month PedMIDAS could vary as a function of the date(s) of administration

relative to the school year. These potential Caspase inhibitor in vivo scoring inconsistencies must be identified and addressed if the instrument is to be used satisfactorily as an outcome measure in clinical research. The aim of the current study was to compare headache frequency, PedMIDAS-based headache disability, and headache intensity for school days vs non-school days and, separately, for the school year vs the summer holiday. An Internet-based headache diary was used to track all study MCE variables. We conducted a prospective study of 52 patients with migraine or probable migraine over an 11-month period of time from December 2011 to October 2012. Each patient completed a 90-day Internet headache diary which incorporated PedMIDAS-based questions, revised to address

headache disability for each headache day. Headache frequencies, disability scores, and intensity ratings were compared for school vs non-school days and for the school year vs the summer holiday. This study was approved by the Institutional Review Board at Nationwide Children’s Hospital. Written informed consent (parents and subjects 18 years of age) and assent (subjects <18 years) were obtained in all cases. Patients ranged in age from 10–18 years, and all had clinical histories consistent with episodic migraine (with or without aura) or probable migraine based on International Headache Society criteria.[7] We included patients with 1–15 headaches monthly. Migraine patients who also had episodic tension-type headaches were not excluded provided that their migraines occurred ≥1 day per month, and the frequency of all combined headaches remained ≤15 days per month. The sample size was chosen empirically (goal of n = 50) to include adequate variations in patient age, headache frequency, and migraine disability. The Internet diary has been previously described.