Abstract
The Headache Impact Test-6™ is a widely recommended questionnaire to evaluate the impact of headaches. However, its measurement properties were never evaluated in both primary and secondary headaches, and the Brazilian Portuguese version of the questionnaire was never assessed at all. To assess the reliability, and structural and construct validity of the Headache Impact Test-Brazil™ in patients with primary and secondary headaches. In total, 132 patients with primary and secondary headaches were included, screened from a headache tertiary clinic. They completed the Headache Impact Test-Brazil™ questionnaire, the 12-Item Short-Form Survey (SF-12), and the Headache Disability Inventory-Brazil. Pearson's correlation analysis was performed among the three questionnaires for validity assessment. One to three weeks after the first application, the Headache Impact Test-Brazil™ was answered again by 67 patients for reliability assessment. The validity sample consisted of 86/132 (65.1%) patients with primary and 46/132 (34.9%) secondary headaches, with mean age of 39.6 (SD: 12.7) years. The reliability sample consisted of 39/67 (58.2%) patients with primary and 28/67 (41.8%) secondary headaches, with mean age of 36.8 (12.5) years. According to the confirmatory factor analysis, the Headache Impact Test-Brazil™ consists of single factor. Its internal consistency was α=0.97 and the question number 3 had the lowest factor loading (0.31). The Headache Impact Test-Brazil™ exhibited a moderate correlation with both the SF-12 questionnaire (r=-0.64, 95%CI: -0.72 to -0.52, p=0.001) and the Headache Disability Inventory-Brazil (r=0.67, 95%CI: 0.56 to 0.75, p=0.001). The correlation between the Headache Impact Test-Brazil™ and the headache frequency was weak (r=0.22, 95%CI: 0.04 to 0.39, p=0.001), and with the headache intensity, moderate (r=0.44, 95%CI: 0.23 to 0.62, p=0.001). The Headache Impact Test-Brazil™ test-retest reliability was excellent (ICC=0.95) with a standard error of 1.58 and a smallest detectable change of 4.38 points. The Headache Impact Test-6-Brazil™ can be considered as a valid and reliable tool to assess the impact of several headache types. Future studies may revise the questionnaire items to confirm its redundancy.
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