Pathways: New App Revolutionizes Migraine Diagnosis in Rural Areas
Migraine Referral Optimization app Heading link
A team comprised of UICOMP faculty and OSF HealthCare partners collaborated to develop a mobile application (app) to transform the way migraine is diagnosed and managed, particularly in rural communities where access to specialized care is limited.
The app, called Migraine Referral Optimization (MiGRO), will facilitate the proper diagnosis of migraine, provide recommendations for initial management, and enable timely referrals to specialized headache clinics. The user-friendly app will be accessible on smartphones and tablets and available in multiple languages.
Designed with both healthcare providers and the general population in mind, MiGRO will improve access to accurate and timely migraine diagnosis and treatment.
Migraine is a common neurological disorder affecting millions worldwide. It is ranked by WHO as the second most prevalent neurologic disorder and the seventh highest specific cause of disability.
Despite its prevalence, there is a lack of access to headache specialists, particularly in underserved areas. Many individuals face barriers to healthcare, including financial limitations, lack of insurance, and transportation difficulties. Additionally, cultural and linguistic differences can hinder accurate diagnosis and management.
The current standard of care for diagnosing headaches involves taking a detailed medical history, performing physical examination, and sometimes conducting additional tests, which add to healthcare costs. However, most uncomplicated migraines can be diagnosed based on history and examination alone.
Misdiagnosis of migraine and medication overuse headache (MOH) happen regularly in non-specialized clinics, particularly in remote communities. Delays in accurate diagnosis, treatment, and timely referrals can lead to transformation of episodic migraine into chronic, refractory type impacting patients’ quality of life and productivity.
Yelena Nersesyan says, “For many general practitioners the problem isn’t necessarily a lack of guidelines of medical knowledge but the logistical challenges in primary care, particularly related to time constraints when dealing with multiple health conditions, and the absence of objective diagnostic testing for migraine.”
To address these issues, the MiGRO app provides a simple, quick digital decision tree algorithm that can be used on any smartphone, tablet or other mobile device. The core diagnostic algorithm of MiGRO consists of simple questions based on the diagnostic criteria for migraine from International Classification of Headache Disorders (ICHD-3), and the algorithm provides an expedited migraine diagnosis, offers recommendations for initial management, and can facilitate timely referrals to headache specialists.
The beta version of the app has proven capable of accurately diagnosing migraine in a recently completed retrospective chart review study.
Initial testing at the Illinois Neurological Institute (INI) Headache and Craniofacial Pain Clinic shows promising results. The app demonstrated higher diagnostic performance for migraines and MOH compared to traditional referral methods and effectively ruled out secondary headaches. Additionally, the app prioritizes referrals for severe or complicated cases needing speedy specialty care.
The research team plans further validation of the diagnostic accuracy of MiGRO to enhance performance and prepare it for use in primary care settings.
The MiGRO app project received funding from both the Community Health Advocacy (CHA) program and Jump Applied Research in Community Health through Engineering and Simulation (ARCHES) partnership.
This article is part of the Fall/Winter 2024-2025 issue of Pathways magazine.