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MIDAS Migraine Disability Test (5 questions)

Take the validated 5-question MIDAS migraine disability test in 60 seconds. Stewart & Lipton 2001, AAN-endorsed. Free, no signup, results stay in.

Last updated: Sources verified:

What you are about to take

The MIDAS questionnaire measures how many days a migraine has limited your activity over the past 3 months. Five questions cover work or school missed, household tasks limited, and social events skipped. About 60 seconds. No signup. Walter F. Stewart and Richard B. Lipton developed MIDAS in 1999, validated it across multiple countries (Stewart 2000, Neurology), and the American Academy of Neurology lists it as the primary disability-screening tool for adult migraine. Your answers stay in your browser — we never see them. Start the test below ↓

✓ Validated by Stewart & Lipton (1999/2000, Neurology) ✓ Listed in AAN/AHS 2019 migraine guideline ✓ 60 seconds, 5 questions ✓ Private — answers never leave your device

How MIDAS is calculated

You enter the number of days, in the past 3 months, that migraine impacted five areas of life: work/school missed, work productivity halved, household tasks missed, household productivity halved, social or leisure events skipped. Items 1-5 sum to a single total. Items 6 and 7 (headache frequency and average pain intensity) are informational only and do not enter the disability score.

Total daysMIDAS gradeDisability levelWhat the band typically means
0–5Grade ILittle or noneCurrent management is working or migraine is infrequent
6–10Grade IIMildWorth a family-doctor conversation about rescue medication
11–20Grade IIIModerateNICE and AAN both recommend discussing preventive medication
21+Grade IVSevereNeurology referral is reasonable; combination therapy is standard

The grade is more useful than the raw number. Stewart 1999 reported a test-retest reliability of about 0.80 for the disability score, which is good for a brief self-report instrument — but a difference of 2–3 days between two MIDAS administrations is within normal measurement noise. A grade shift, on the other hand, is a real signal.

When this test is useful — and when it isn’t

Useful for:

  • Tracking whether your current treatment is reducing disability across quarters
  • Bringing a quantified score to a doctor’s visit (instead of “my migraines are bad”)
  • Distinguishing high-frequency episodic from chronic migraine alongside a headache diary

Not useful for:

  • Diagnosing migraine — only a clinician using ICHD-3 criteria does this
  • Capturing single-attack severity (HIT-6 is better for this)
  • Children — there is a paediatric MIDAS (PedMIDAS) for ages 4–18 with a different scoring scheme

Migraine disability vs frequency vs intensity — what each measures

A common confusion: people equate “many migraine days” with “severe disability”. They are related but not identical.

Frequency (headache days per month) determines whether migraine is episodic (<15 days/month) or chronic (≥15 days/month) per ICHD-3. Intensity (pain 0–10) describes how a typical attack feels. Disability (MIDAS) measures the actual functional cost — days lost from work, home, and social life. A person can have 10 monthly migraine days but high disability if each attack lasts 12 hours and ruins the day; another can have 12 monthly migraine days but low MIDAS if their treatment cuts each attack to 2 hours. All three numbers belong on a doctor’s visit.

  • PHQ-9 depression screener — depression is the most common migraine comorbidity (Buse 2013, Headache)
  • GAD-7 anxiety screener — anxiety co-occurs in around 1 in 3 chronic-migraine patients
  • BMI calculator — obesity is a risk factor for progression from episodic to chronic migraine (Bigal 2006, Neurology)

Sources verified 2026-05-17

  • Stewart WF, Lipton RB, Whyte J, et al. An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score. Neurology 1999;53:988-994. (PMID 10496258)
  • Stewart WF, Lipton RB, Kolodner K, Sawyer J, Lee C, Liberman JN. Reliability of the Migraine Disability Assessment Score in a population-based sample of headache sufferers. Cephalalgia 1999;19:107-114. (PMID 11098098)
  • American Academy of Neurology / American Headache Society. Practice guideline: acute and preventive treatment of migraine. 2019. (PMID 31413171)
  • National Institute for Health and Care Excellence. Headaches in over 12s: diagnosis and management (CG150). Last updated 2021.
  • International Headache Society. International Classification of Headache Disorders, 3rd edition (ICHD-3). Cephalalgia 2018;38(1):1-211.

Privacy

The MIDAS calculation runs entirely in your browser. Your individual day-counts and the calculated grade never leave your device. We send one anonymous event to a privacy-respecting analytics service: your locale code and the MIDAS band string (for example grade_ii). No raw answers, no per-item data, no identifier of any kind.

Frequently asked questions

What does a MIDAS score of 15 mean?
A MIDAS score of 15 places you in Grade III (moderate disability, range 11–20). Stewart & Lipton 1999 set this band as the threshold where preventive treatment (not just rescue medicines) usually pays off. NICE CG150 and the AAN/AHS 2019 guideline both recommend a doctor visit at this level — not because it is dangerous, but because better options exist than enduring 11–20 disability days every quarter.
At what MIDAS score is migraine considered disabling?
MIDAS counts disability from any score above 5 (Grade II onwards). Grade II (6–10 days lost in 3 months) is mild, Grade III (11–20) is moderate, Grade IV (21+) is severe. AAN/AHS 2019 treats Grade III and IV as the clinical thresholds for adding preventive medication; Grade IV typically warrants a neurology referral.
Should I see a neurologist for migraine?
Most people manage migraine with their family doctor. A neurologist referral is reasonable at MIDAS Grade IV (21+ days/3 months), at chronic migraine (15+ headache days/month), or if first-line preventives (topiramate, propranolol, amitriptyline) failed. NICE CG150 lists these as referral triggers.
MIDAS vs HIT-6 — what is the difference?
MIDAS measures days of lost or impaired activity over 3 months. HIT-6 measures the impact of pain on a single average headache day. MIDAS is the better tool for tracking change across months; HIT-6 is faster (6 quick questions) and is preferred by some clinics for a single-visit snapshot. Both are validated; the AAN/AHS 2019 lists MIDAS as the primary disability tool.
How often should I retake the MIDAS test?
Every 3 months. The questionnaire asks about the past 3 months, so retaking it more often gives overlapping windows. Stewart & Lipton 2000 (Neurology) recommend MIDAS at every clinical visit as a tracking tool. A drop of one grade between visits is a strong sign your strategy is working.
Is migraine the same as a tension headache?
No. Migraine and tension-type headache are separate conditions in ICHD-3 (International Headache Society 2018). Migraine is typically one-sided, throbbing, moderate-to-severe, often with nausea, light or sound sensitivity, and lasts 4–72 hours. Tension headache is bilateral, pressing, mild-to-moderate, without nausea. MIDAS is designed for migraine; HIT-6 covers both.
What are the most common migraine triggers?
Stewart 2008 (Neurology) ranks the top reversible triggers: irregular sleep, skipped meals, dehydration, screen glare, alcohol (red wine especially), strong scents, and hormonal cycle. Stress is a trigger and an aftermath. Identifying 2–3 personal triggers via a headache diary is more effective than avoiding a generic 'migraine trigger list'.
How does migraine interact with women's hormonal cycle?
Roughly 60% of women with migraine notice a menstrual pattern (Pavlovic 2017, Headache). Migraine usually peaks 2 days before to 3 days after period onset, when estrogen drops sharply. Combined hormonal contraceptives are contraindicated in migraine with aura — they raise stroke risk (NICE CG150). Pure menstrual migraine often responds to short triptan courses around the period.
Migraine and pregnancy — what changes?
About 50–80% of women with migraine have fewer attacks in the second and third trimesters (Sances 2003, Cephalalgia). The first trimester can be worse. Triptans and most preventives are avoided in pregnancy; paracetamol is first-line. A new severe headache during pregnancy needs same-day medical review — pre-eclampsia must be ruled out.
Can the MIDAS score be wrong?
MIDAS can under-count or over-count for two reasons. Recall bias — most people round 'how many days' from memory, and brain-fog days in the migraine prodrome are easy to miss. The questionnaire also asks only about activity lost; severe pain on a day you forced yourself through does not count. Test-retest reliability is around 0.80 in Stewart 1999, which is good for a self-report tool but not perfect.
What should I do if my MIDAS score is high but my doctor dismisses it?
Bring the score plus a 4-week headache diary (date, intensity 0–10, suspected trigger, medication taken). NICE CG150 and AAN/AHS 2019 both treat MIDAS Grade III and IV as documented referral thresholds. If your GP will not refer, asking for a second opinion or a neurology referral in writing is reasonable — and is your right under most health systems.
Does the MIDAS test stay private?
Yes. The calculator runs entirely in your browser. Your individual answers never leave your device. We log one anonymous event with the MIDAS grade band (e.g. 'grade_iii'), nothing more — no raw answers, no IP, no identifier.

Sources

  1. An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score — Stewart WF, Lipton RB, Whyte J, et al. — Neurology (1999) (peer reviewed, retrieved 2026-05-17)
  2. Reliability of the Migraine Disability Assessment Score in a population-based sample of headache sufferers — Stewart WF, Lipton RB, Kolodner K, et al. — Cephalalgia (1999/2001) (peer reviewed, retrieved 2026-05-17)
  3. Practice guideline update summary: Acute treatment of migraine in children and adolescents — American Academy of Neurology / American Headache Society (AAN/AHS, 2019) (guideline, retrieved 2026-05-17)
  4. Headaches in over 12s: diagnosis and management (CG150) — NICE (UK, last updated 2021) (guideline, retrieved 2026-05-17)
  5. International Classification of Headache Disorders, 3rd edition (ICHD-3) — International Headache Society (2018) (guideline, retrieved 2026-05-17)