Headache Impact Test (HIT-6)

The Headache Impact Test (HIT-6) is a questionnaire for measuring the impact of headache. A total of six questions are completed by the patient. They focus on daily activities such as work, education, home situation and leisure time. The HIT-6 gives a general overview of the impact of headache, including pain intensity, impairment and other items. A higher score corresponds to higher impact.

Validity and Reliability

The Headache Impact Test (HIT-6) is a widely used tool for assessing the impact of headaches on individuals’ lives. It has been validated and shown to have good psychometric properties (Rendas-Baum et al., 2014; Bera et al., 2014; Kothari et al., 2022; Houts et al., 2020).

The questionnaire has been validated for use in different populations, including patients with chronic migraine (Yang et al., 2010; Rendas-Baum et al., 2014; Houts et al., 2020), migraine and tension-type headache (Park et al., 2014; Bera et al., 2014), and individuals with persistent post-traumatic headache (Kothari et al., 2022). The HIT-6 has been found to be reliable and valid in assessing the impact of headaches in these populations (Yang et al., 2010; Rendas-Baum et al., 2014; Park et al., 2014; Bera et al., 2014; Kothari et al., 2022; Houts et al., 2020).

The HIT-6 is easy to administer and has good accessibility (Bera et al., 2014). Overall, the HIT-6 is a valuable tool for researchers and clinicians in assessing the impact of headaches and guiding treatment decisions.

Scoring and Interpretation

Each of the six questions of the HIT-6 receives a score from 6-13. The final HIT-6 score can range from 36 to 78. A higher score indicates more disability due to headache.

The four categories of headache impact severity are:

• little or no impact (49 or less)
• some impact (50–55)
• substantial impact (56–59)
• severe impact (60–78)

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References

Bayliss, M. S., & Batenhorst, A. S. (2002). The HIT-6™ a user’s guide. Lincoln, RI: QualityMetric Incorporated.

Bendtsen, L., Bigal, M., Cerbo, R., Diener, H., Holroyd, K., Lampl, C., … & Tfelt-Hansen, P. (2009). Guidelines For Controlled Trials Of Drugs In Tension-type Headache: Second Edition. Cephalalgia, 1(30), 1-16. https://doi.org/10.1111/j.1468-2982.2009.01948.x

Bera, S., Khandelwal, S., Sood, M., Goyal, V. (2014). A Comparative Study Of Psychiatric Comorbidity, Quality Of Life and Disability In Patients With Migraine And Tension Type Headache. Neurol India, 5(62), 516. https://doi.org/10.4103/0028-3886.144445

Dimitrova, A., Ungaro, R., Lebwohl, B., Lewis, S., Tennyson, C., Green, M., … & Green, P. (2012). Prevalence Of Migraine In Patients With Celiac Disease and Inflammatory Bowel Disease. Headache: The Journal of Head and Face Pain, 2(53), 344-355. https://doi.org/10.1111/j.1526-4610.2012.02260.x

Houts, C., McGinley, J., Wirth, R., Cady, R., Lipton, R. (2020). Reliability and Validity Of The 6-item Headache Impact Test In Chronic Migraine From The Promise-2 Study. Qual Life Res, 3(30), 931-943. https://doi.org/10.1007/s11136-020-02668-2

Kothari, S., Svendsen, S., Tuborgh, A., Rask, C., Schröder, A., Kasch, H., … & Nielsen, J. (2022). Characterization Of Persistent Post-traumatic Headache and Management Strategies In Adolescents And Young Adults Following Mild Traumatic Brain Injury. Sci Rep, 1(12). https://doi.org/10.1038/s41598-022-05187-x

Park, J., Moon, H., Kim, J., Lee, K., Chu, M. (2014). Chronic Daily Headache In Korea: Prevalence, Clinical Characteristics, Medical Consultation and Management. J Clin Neurol, 3(10), 236. https://doi.org/10.3988/jcn.2014.10.3.236

Rendas-Baum, R., Yang, M., Varon, S., Bloudek, L., DeGryse, R., Kosinski, M. (2014). Validation Of the Headache Impact Test (Hit-6) In Patients With Chronic Migraine. Health Qual Life Outcomes, 1(12). https://doi.org/10.1186/s12955-014-0117-0

Yang, M., Rendas-Baum, R., Varon, S., Kosinski, M. (2010). Validation Of the Headache Impact Test (Hit-6™) Across Episodic And Chronic Migraine. Cephalalgia, 3(31), 357-367. https://doi.org/10.1177/0333102410379890

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