Cross-cultural adaptation, validity, and reliability of the Visual Aura Rating Scale (VARS) for the Brazilian version

• Grant number: 24/07613-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2024
• End date: April 30, 2026
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Débora Bevilaqua Grossi
• Grantee: Maria Luiza Santana Barros
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated scholarship(s): 25/04151-0 - Reproducibility of visual sensitivity tests Quantitative Thresholds of Light Sensitivity and Pupillary Responses to Light., BE.EP.IC

Abstract

Migraine is a highly disabling primary headache that may be accompanied by aura. Aura is a set of transient neurological symptoms that can take various forms, the most common being visual type. Individuals with this type of migraine are at greater risk of vascular disease and vestibular disorders associated with balance impairment and falls. The diagnosis of migraine with aura is clinical and given by a neurologist based on the International Classification of Headache Disorders (ICHD-3). The Visual Aura Rating Scale (VARS) was developed to facilitate and standardize the diagnosis of visual aura. The scale consists of 5 questions regarding the duration of aura, gradual onset, presence of scotomas or zigzag lines, location, temporal relationship with the headache. The score ranges from 0 to 10, and the aura diagnosis is given for a score greater than or equal to 5. While it is extremely useful, its psychometric properties have not yet been tested for the Brazilian population. Therefore, this project aims to translate and cross-culturally adapt the VARS, and assess its criterion validity and reliability in the Brazilian population. The study will include individuals from the Headache and Craniofacial Algias Outpatient Clinic at the Hospital das Clínicas of the Ribeirão Preto Medical School of the University of Sao Paulo (ACEF-HCFMRP/USP), aged between 18 and 65 and a diagnosis of migraine according to ICHD-3 criteria. Individuals will be excluded if they are diagnosed with secondary headache or illiterate/unable to understand the questionnaire. Initially, 30 individuals will be assessed for the initial phase of cross-cultural adaptation. The translation and adaptation process consists of six phases. This questionnaire will be applied to a new sample of 60 individuals for validity and reliability. The questionnaire will be administered again to the same sample three weeks after the first application for test-retest reliability. Demographic data and clinical characteristics of migraine will be collected. For the statistical analysis, the criterion validity will be assessed by analyzing the ROC curve, using sensitivity and specificity, and the ICHD-3 will be used as a comparison criterion as a "gold standard". Reliability will be calculated using the Intraclass Correlation Coefficient and internal consistency with Cronbach's Q coefficient.