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Headache Impact Test-6 (HIT-6)
Please visit this website for more information about the instrument: Headache Impact Test.
NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a Migraine or Headache-Specific Health-Related Quality of Life measure.
Supplemental - Highly Recommended: Headache.
Short Description of Instrument
The Headache Impact Test™ (HIT-6™) is a tool that measures the impact headaches have on a person's ability to function on the job, at home, at school, and in social situations. The test was developed by an international team of headache experts from neurology and primary care medicine in collaboration with the psychometricians who developed the SF-36® health assessment tool.
The HIT builds on previous work by pooling items from 4 existing measurement instruments: Migraine Specific Questionnaire (MSQ), Headache Disability Inventory (HDI), Headache Impact Questionnaire (HIMQ), and Migraine Disability Assessment Score (MIDAS).
Items cover a broader spectrum of health outcomes than any of the original scales, ranging from pain to emotional distress. The HIT-6™ is a static, short-form version of the HIT™ for paper-and pencil administration. The recall period for this assessment is 4 weeks. A CAT version is available.
Scoring and Psychometric Properties
Scoring: The HIT-6™ consists of six items: pain, social functioning, role functioning, vitality, cognitive functioning, and psychological distress. The respondent answers each question using one of the following five responses: "never", "rarely", "sometimes", "very often", or "always". The HIT-6™ total score is the sum of the summed responses. The total score ranges from 36 to 78, where a higher score indicates a greater impact of headache on the daily life of the respondent. (Bayliss & Batenhorst, 2002; Bayliss et al., 2003; Shin et al., 2008)
Psychometric Properties: For a discussion of the validity of the HIT-6™ see: Houts et al., 2020; Kosinski et al., 2003 and Rendas-Baum et al., 2014.

Scores from the six questions are added to create a total score that helps you better describe the impact of headache on your life.

Bayliss M, Batenhorst A. The HIT-6: A User's Guide. Lincoln, RI: Quality Metric, Inc.: 2002.
Bayliss MS, Dewey JE, Dunlap I, Batenhorst AS, Cady R, Diamond ML, Sheftell F. A study of the feasibility of Internet administration of a computerized health survey: the headache impact test (HIT). Qual Life Res. 2003 Dec;12(8):953-961.
Gagne JJ, Leas B, Lofland JH, Goldfarb N, Freitag F, Silberstein S. Quality of care measures for migraine: a comprehensive review. School of Population Health Faculty Papers. Paper 39. 2007.
Houts CR, Wirth RJ, McGinley JS, Gwaltney C, Kassel E, Snapinn S, Cady R. Content Validity of HIT-6 as a Measure of Headache Impact in People With Migraine: A Narrative Review. Headache. 2020 Jan;60(1):28-39.
Kosinski M, Bayliss MS, Bjorner JB, Ware JE Jr, Garber WH, Batenhorst A, Cady R, DahlÖf CG, Dowson A, Tepper S. A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res. 2003 Dec;12(8):963-74.
Rendas-Baum R, Yang M, Varon SF, Bloudek LM, DeGryse RE, Kosinski M. Validation of the Headache Impact Test (HIT-6) in patients with chronic migraine. Health Qual Life Outcomes. 2014 Aug 1;12:117.
Shin HE, Park JW, Kim YI, Lee KS. Headache Impact Test-6 (HIT-6) scores for migraine patients: Their relation to disability as measured from a headache diary. J Clin Neurol. 2008 Dec;4(4):158-63.
Document last updated January 2022