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Validation of the Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQ v. 2.1) for patients undergoing prophylactic migraine treatment

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Health-related quality of life (HRQoL) is an important outcome measure of migraine treatments. Although a number of migraine-specific HRQoL questionnaires exist, their measurement characteristics have only been examined for patients undergoing acute treatment of migraine. The goal of the current study was to evaluate measurement properties of the widely used Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQ v. 2.1) within a group of patients undergoing prophylactic migraine treatment.


Various measurement properties of the MSQ were examined in a sample of 916 migraineurs undergoing prophylactic treatment who had scores at baseline and follow-up, as well as baseline SF-36. First, we used confirmatory factor analysis (CFA) and differential item functioning (DIF) to assure the accuracy and stability across groups of the MSQ scoring for all three subscales (Role Restrictive, Role Preventive, and Emotional Functioning). Next, item- and scale-level properties were examined, such as item-total correlations, internal consistency, and convergent and discriminant validity.


Initial findings revealed that item 12 (measuring frustration on the Emotional Functioning subscale) performed poorly. Subsequent to its removal, the 13-item MSQ displayed excellent measurement properties, including stable latent structure at baseline and endpoint, no gender or age biases on items, appropriate item-level and scale-level reliabilities, and markedly higher convergent validity compared to discriminant validity.


The 13-item MSQ appears to be an appropriate measure of migraine-specific HRQoL for patients undergoing migraine prophylaxis. Moreover, given the stability of the latent structure over time, the interpretation of scores is likely to remain quite consistent throughout a clinical trial.

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Fig. 1

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  1. Residuals refer to the variance that is not accounted for by the relationship of a particular domain to its latent variable. For example, when examining MSQ item 1 (time with family) and RR (see Fig. 1), the residual of item 1 is all of the variance not otherwise accounted for by the path coefficient from RR to item 1 (i.e., the current modeled relationship), or 1—the square of the standardized coefficient (i.e., .752 = .436) for standardized values.

  2. Figure 1 shows the strength of the relationship between each latent factor and its reflective items. Weights on the path are standardized path coefficients, and squaring these path coefficients is akin to the amount of explained variance: item 1 has a coefficient of .91, which squared is equal to 82.8% explained variance. Thus, the latent factor of Role Restrictive explains 82.8% of the variance for item 1. Values on the curved paths between the factors indicate the size of the interfactor correlations.



Confirmatory factor analysis


Comparative fit index


Differential item functioning


MSQ emotional function domain


Goodness of fit index


Headache Disability Inventory


Headache Impact Test 6-item


Item response theory


Migraine-Specific Quality of Life Questionnaire


Nonnormed fit index


Root mean square error of approximation


MSQ role preventive domain


MSQ role restrictive domain


Medical Outcomes Study Short Form 36


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This work was supported by funding from Ortho-McNeil-Janssen Scientific Affairs.

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Correspondence to Jason C. Cole.

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Cole, J.C., Lin, P. & Rupnow, M.F.T. Validation of the Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQ v. 2.1) for patients undergoing prophylactic migraine treatment. Qual Life Res 16, 1231–1237 (2007).

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