Functional Assessment in Migraine (FAIM) Questionnaire: Development of an Instrument Based Upon the WHO's International Classification of Functioning, Disability, and Health

Abstract Objective The goal of this project was to develop a migraine functional measurement instrument, derived from the World Health Organization International Classification of Impairments, Disabilities, and Handicaps version 2 classification system, which focuses on functional outcomes, and is both reliable and valid. Methods The Functional Assessment in Migraine (FAIM) questionnaire was developed using a multistep approach to ensure the brevity, relevance, reliability, and validity of items. A test set of 71 Mental Functioning and 50 Activity and Participation items was generated and administered to migraineurs in the United States and Germany. A subset of 22 Mental Functioning and 28 Activity and Participation items that rated highly on frequency-weighted importance and showed strong psychometric properties was piloted to determine a final item set and to test reliability and validity. Results The final version of the FAIM included nine Mental Functioning items measuring the dimensions of Attention/Thought (5 items) and Perception (4 items), and a list of 28 Activity and Participation items from which respondents chose the five items most relevant to their lifestyle. Construct validity analysis of FAIM dimensions found significant positive correlations with self-reported symptom severity, moderately significant positive correlations with dimensions of the Migraine-Specific Quality of Life questionnaire and no significant correlation with Short Form Health Survey (SF-12) component scores. Conclusion The FAIM offers physicians a brief and valid method of measuring the impact of migraine on mental functioning and activity and participation as defined by the WHO International Classification of Functioning, Disability, and Health. Additional testing is underway to assess its responsiveness to change.