I'm Getting a Migraine: A Comparative Evaluation of Patient and Clinician Interpretations of Migraine Symptoms

Background: Patients and providers vary in how they describe common otolaryngology-related complaints. These differences can lead to miscommunication and frustration that may affect patient outcomes and satisfaction. The aim of this cross-sectional survey-based study was to explore the differences in migraine symptom selection by otolaryngology patients and clinicians. Methods: Between June 2020 and October 2022, patients and otolaryngology providers at 5 academic medical centers were asked to select as many symptoms as they felt were related to migraine from a list of 28 common symptom terms in 6 domains: headache-related, eye-related, systemic, sinonasal, facial, and ear-related. The primary study outcome was to assess the differences in patient and clinician perceptions of migraine-related symptoms. A secondary outcome was to assess differences by geographic location. Results: A total of 381 patients and 31 otolaryngology clinicians participated. Patients and providers selected a similar number of symptom terms to define migraine, selecting a median of 10 and 11 symptoms, respectively. Otolaryngology clinicians were more likely than patients to define migraine using eye-related symptoms (difference 10.5%; 95% CI 7.4%, 13.6%) and ear-related symptoms (difference 17.2%; 95% CI 3.4%, 31.0%). Patients were more likely to define migraine using facial symptoms (difference -17.3%; 95% CI -34.1%, -0.5%). Otolaryngologists and patients were equally likely to select headache-related, sinonasal, and systemic symptoms when defining migraine. Minor differences were identified based on geographic location. Conclusion: We found differences between otolaryngologists and their patients in the interpretation of the symptoms of migraine. Clinicians were more likely than patients to describe migraine using eye-related and ear-related symptoms, whereas patients were more likely to describe migraine using facial symptoms. These findings have important counseling and communication implications for clinicians.