Translation, cross-cultural adaptation, and validation of a Latin American Spanish version of the ID Migraine screening test.

OBJECTIVE: To translate, culturally adapt, and validate a version of the ID Migraine into Latin American Spanish. BACKGROUND: Although still considered a common diagnosis, half of the patients with migraine in Latin America experience diagnostic delay. The ID Migraine is a test developed in 2003 as a valuable tool for the early diagnosis of migraine at the primary care level; however, there is no validated Spanish or culturally adapted version for the Spanish-speaking population. METHODS: This is an analytical, translation, and test-validation study. We performed back translation and cross-cultural adaptation. The Latin American Spanish version ID Migraine MX was applied to headache clinic patients from March 2021 to January 2022 to perform a validation process against the gold standard: blinded expert diagnosis according to the International Classification of Headache Disorders, 3rd edition (ICHD-3), criteria. RESULTS: One hundred seventeen patients from the headache clinic of the National Institute of Neurology and Neurosurgery of Mexico City were screened. We found 62/117 (53%) patients positive for screening with ID Migraine MX, and 47/117 (40%) positive for migraine according to ICHD-3 criteria. A sensitivity (95% CI) of 0.91 (0.80-0.97), specificity of 0.73 (0.61-0.82), positive predictive value of 0.694 (0.57-0.794), and negative predictive value of 0.93 (0.83-0.97) were obtained. The positive likelihood ratio was 3.38 (2.27-4.99), and the negative likelihood ratio was 0.12 (0.04-0.30). After calling the patients 1 month after the first interview, the calculated Kappa test-retest was 0.75 (p = 0.001). CONCLUSION: A translated and cross-culturally adapted version into Spanish of the ID Migraine was obtained, with a diagnostic performance similar to the original instrument. Clinicians may use this test at the first level of care to reduce the rate of misdiagnosis and the time from onset of symptoms to diagnosis and treatment of migraine.

El mal paraje y la mala hora: notas sobre la violencia naturalista hacia el saber médico andino / Mal paraje and mala hora: remarks on the naturalistic violence towards Andean medical knowledge

RESUMEN Las nociones locales de mal paraje y mala hora son claves para explicar los orígenes de muchas enfermedades en el saber médico andino. Pese a su importancia etnográfica, ni la investigación antropológica ni el saber biomédico han tratado adecuadamente estas distinciones locales, relegándolas muchas veces al olvido. Nuestro objetivo es explorar el origen de esta limitación de la producción antropológica y biomédica. La hipótesis es que se relaciona con la utilización implícita de ciertos supuestos teóricos naturalistas a la hora de abordar este fenómeno, tanto de parte de las ciencias sociales como de los saberes biomédicos, lo que produce una violencia simbólica y epistémica contra el saber médico andino que denominamos violencia naturalista. Respecto a la metodología, se analizó información etnográfica sobre la comunidad Aymara de Camiña (Tarapacá, Chile) y la principal literatura producida. Centramos nuestro análisis en las nociones de mal paraje y mala hora, utilizando la técnica de análisis de contenido. Concluimos que los principales obstáculos naturalistas se manifiestan en el tratamiento que reciben las entidades territoriales, las relaciones que se establecen entre éstas y los seres humanos (reciprocidad), y las concepciones de espacio/tiempo presente en el diagnóstico de una enfermedad.

ABSTRACT The local notions of mal paraje [bad place] and mala hora [bad time] are key to explaining many illnesses in Andean medical knowledge. Notwithstanding the relevance of these notions ethnographically, neither anthropological research nor biomedical knowledge has properly dealt with these local distinctions, and have largely relegated them to the shadows. Our aim is to examine the origin of this shortcoming of anthropological and biomedical knowledge production. Our hypothesis is that such shortcoming is related to the implicit use of certain naturalistic theoretical presuppositions, both from the point of view of social sciences and from the point of view of biomedical research, producing symbolic and epistemic violence against Andean medical knowledge which we call naturalistic violence. In methodological terms we examine ethnographic data from the Aymara community of Camiña (Tarapacá, Chile) and the literature produced on this topic. We focus on the notions of mal paraje and mala hora using the content analysis technique. We conclude that the main naturalistic obstacles include the treatment received by territorial entities, the relationships established among these entities and human beings (reciprocity), and the conceptions of space/time present in the diagnosis of a disease.