What Is the MIDAS Questionnaire?
The Migraine Disability Assessment (MIDAS) questionnaire is a brief, self-administered tool designed to measure the impact of headaches on daily life. Developed by Dr. Richard Lipton and his team, it has become a gold standard in both clinical practice and research for quantifying headache-related disability.
Key Items and Scoring
The MIDAS consists of five core questions that ask about missed days of work, school, household chores, and family/social activities over the past three months. Respondents also note the number of headache episodes in that period. Scores range from 0 to 270, with higher numbers indicating greater disability.
- Grade I (0–5): Little or no disability
- Grade II (6–10): Mild disability
- Grade III (11–20): Moderate disability
- Grade IV (21 ): Severe disability
Why Use MIDAS?
The MIDAS questionnaire is valued for its simplicity, reproducibility, and validity. It helps clinicians quickly assess the burden of migraine and tailor treatment plans accordingly. For people with migraine, it provides a clear way to communicate their experience to doctors.
Keywords to Remember
When reading about or using the MIDAS, watch for these important terms:
- Migraine Disability Assessment (MIDAS) – the full name of the tool
- Headache-related disability – the core concept measured
- Missed days – a key outcome in the five questions
- Reduced productivity – captured by the "at least half" reduction in activity
- Three-month recall period – the timeframe of the assessment
- Grade I–IV – the severity classification system
- Clinician‑administered / self‑report – how the questionnaire is used
- Treatment planning – the main clinical application
Clinical Importance
A high MIDAS score often triggers more aggressive preventive therapy. Studies show that people with Grade IV disability benefit most from targeted interventions, such as CGRP inhibitors or neuromodulation devices. The questionnaire also helps monitor treatment response over time.
Limitations and Complementary Tools
While the MIDAS is excellent for tracking disability, it does not measure pain intensity, frequency of attacks, or quality of life in depth. Many clinicians pair it with tools like the Headache Impact Test (HIT-6) or a daily headache diary for a more complete picture.
The MIDAS questionnaire remains an essential, evidence-based instrument for anyone managing migraine – from primary care physicians to headache specialists and researchers.