Headache Impact Test



International Knee Documentation Committee (IKDC)

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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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

Copyright Notice

When available, sources are cited, and the tool’s developer retains ownership of the intellectual property. We consider that the modification and creation of these tools into dynamic, interactive, online scoring calculators is fair usage. Please email us if you believe we have violated your copyright so we can take down the offending material.


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