Validity and reliability of the self‐administered Visual Aura Rating Scale questionnaire for migraine with aura diagnosis: A prospective clinic‐based study

Objective To assess the validity and reliability of the self‐administered Visual Aura Rating Scale (VARS) questionnaire using a hospital‐based sample in a cross‐sectional setting. Background Visual aura is the most common type of aura manifesting in 98%‒99% of migraine with aura (MA). The VARS is a diagnostic rating scale used to quantify the cardinal characteristics of MA and has shown high sensitivity and specificity in the diagnosis of visual aura. Methods We translated the VARS into Korean and constructed a five‐item self‐administered questionnaire based on the VARS. We consecutively recruited first‐visit patients with migraine at the neurology clinics of two university hospitals. The scoring of the self‐administered VARS questionnaire was the same as that for the original VARS. We assessed criterion validity and internal consistency reliability. The diagnosis of migraine and aura was assigned by two headache neurologists based on a comprehensive clinical assessment using the International Classification of Headache Disorders, 3rd edition. Results A total of 240 participants with migraine were enrolled. Of these, 55 (22.9%) had MA. All participants with MA had visual aura. Receiver operating characteristic curve analysis revealed that a cutoff score of 3 provided the highest rate of correct identification of patients ([200/240], 83.3%), with a sensitivity of 96.4% (95% confidence interval [CI], 84.5%–99.6%) and specificity of 79.5% (95% CI, 72.9%–85.0%). Cronbach's alpha coefficient was 0.852. Conclusion The self‐administered VARS questionnaire is a valid and reliable instrument for the screening of visual aura in patients with migraine in neurology outpatient clinics.