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<figure id="figure-6g5uzgfj28lzk84a9t"><img id="6g5uzgfj28lzk84a9t" src="https://media.gettyimages.com/id/1368538346/photo/male-doctor-giving-a-speech-on-a-podium-at-a-conference.jpg?b=1&s=2048x2048&w=0&k=20&c=ddPSdSmUNstzA9MtqZhdS998vNU5hYdlh919b9lqS54=" alt="Male doctor giving a speech on a podium at a conference" title="Male doctor giving a speech on a podium at a conference" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 3/2; object-position: center center;" data-corners="default" data-aspect="3:2" data-caption="" data-positionX="undefined" data-positionY="undefined" data-fullWidth="false"/></figure>The American Headache Society Annual Scientific Meeting in San Diego June 13-16, 2024 was, as promised, jam packed with presentations, research and over 500 posters on key aspects of headache and migraine management. &nbsp; In addition to a number of key updates on medications and new formulations we’ll be covering in furture blogs, there were interesting <a title="Why Don't Migraine Patients Seek Treatment?" href="https://www.medscape.com/viewarticle/why-dont-migraine-patients-seek-treatment-2024a1000ber" target="_blank" rel="noopener" data-mce-href="https://www.medscape.com/viewarticle/why-dont-migraine-patients-seek-treatment-2024a1000ber">findings</a> on seeking care for migraine presented by Dr. Elizabeth K. Seng, PhD. &nbsp;Her team found that about 1/3 of patients with migraine were reluctant to seek medical help. &nbsp;There were many reasons for this including, most notabley, not being sure a clinician could offer them anything more than they were doing for themselves. &nbsp;The respondents also noted that most of the information they received was from friends, family and the internet making the quality and information of this information incredibly crucial.&nbsp; &nbsp; These finding point back to our <a title="MigraWell: A Different Approach to Migraine Education and Support" href="https://migrawell.com/blog/migrawell-migraine-support" target="_blank" rel="noopener" data-mce-href="https://migrawell.com/blog/migrawell-migraine-support">first blog</a> and the Mayo Study which discussed the important needs of those with migraine when they worked with healthcare professionals. &nbsp;It also pointed to our team’s research and two poster presented at the same meeting which were featured on <a title="Significant Errors With ChatGPT for Migraine Drug Treatment" href="https://www.medscape.com/viewarticle/significant-errors-chatgpt-migraine-drug-treatment-2024a1000bkw" target="_blank" rel="noopener" data-mce-href="https://www.medscape.com/viewarticle/significant-errors-chatgpt-migraine-drug-treatment-2024a1000bkw">Medscape’s summary of top findings at the meeting</a>. &nbsp; Our first poster[i] “ChatGPT for migraine patient education: Ready for prime time?” noted that ChatGPT4 performed adequately for some migraine education areas but provided sub-optimal responses and outdated responses in others important areas. &nbsp;Basically if patients are predominately relying on the internet as a source for migraine education, it may not provide the information needed to help them access evidence based treatment.&nbsp; &nbsp; This is what motivated us towards our second poster[ii] and to create our Migraine AI Assistant (Maia) which optimized internet responses (such as those received from ChatGPT) to provide more evidence based and personalized answers. &nbsp;This was accomplished both by having clinicians like myself in the loop to vet answers to make sure they were timely and understandable as well as having a group of patients provide feedback to confirm their benefit.&nbsp; &nbsp; Our research found that within a week of using Maia, patients were able to increase their knowledge and confidence in pursing treatment in 11 of 12 (91%) of core areas from medications to procedures to diet and lifestyle. &nbsp;In fact, the only areas where knowledge did not increase was symptoms of migraine which arguably those with migraine know better than anyone else.&nbsp; I think one of the reasons this area was covered by the media was because the internet has become such a place for gathering medical information. &nbsp;The key here is how to harness that information with the appropriate guard-rails so that as those with migraine turn to the internet, the information they receive is able to provide the knowledge and confidence needed to optimized migraine treatment which 1/3 are not currently able to do. &nbsp; That is why I was pleasantly surprised that as we questioned users of Maia regarding how they would use it optimally, they mentioned that it would be great if they could print out the findings and share them with the healthcare team in treatment discussion.&nbsp; &nbsp; We have taken this feedback to allow Maia to collect the dialogue so it can do exactly what users have requested, to create an evidence based prompt for future interactions when planning treatment. &nbsp;In addition, we are beginning the next phase of evaluation where users of Maia, both patients can caregivers, can provide feedback on how Maia is supporting them as well as areas where it can do even more.&nbsp; &nbsp; We look forward to your comments. &nbsp;Dr Bonakdar&nbsp; [i] Bonakdar RA, Sweeney M, Simi J, Youngblood C. ChatGPT for migraine patient education: Ready for prime time? Poster 517. American Headache Society Annual Meeting, 2024.&nbsp; [ii] Sweeney M, Bonakdar RA. Does a migraine AI assistant (Maia) improve patient knowledge and confidence? A pilot evaluation. Poster 516.American Headache Society Annual Meeting, 2024.

Maia Recognized at American Headache Society & Medscape

<figure id="figure-mei72vkgfhlxc8ii3a" class="selected"><img id="mei72vkgfhlxc8ii3a" src="https://cdn.durable.co/shutterstock/3SGC2jjckf5VeE6jjGkaVymzEboOgRCuDGngqzS9lx3Y5xqxdKvGQDF8LUn30JGx.jpeg" alt="Man touching an artificial intelligence concept on a touch screen with his finger" title="Man touching an artificial intelligence concept on a touch screen with his finger" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: center center;" data-corners="default" data-aspect="16:9" data-caption="" data-positionx="undefined" data-positiony="undefined" data-fullwidth="false" data-mce-src="https://cdn.durable.co/shutterstock/3SGC2jjckf5VeE6jjGkaVymzEboOgRCuDGngqzS9lx3Y5xqxdKvGQDF8LUn30JGx.jpeg" data-mce-style="aspect-ratio: 16/9; object-position: center center;"></figure>In today’s blog I would like to introduce you to our research and findings on Maia, the Migraine Artificial Intelligence Assistant developed to support those living with migraine as well as those caring for them. &nbsp; <h2>My Experience with AI in Healthcare&nbsp;</h2>As background we have ALL heard of AI and cannot go through our day without hearing something amazing or scary about AI. &nbsp;But what about in healthcare where the information is more critical? My story with AI in migraine is likely very similar to what many patients and doctors have experienced with AI for health questions. You put a question into ChatGPT or similar and initially are amazed at the quick and snappy response you get like it is a veteran doctor. This initial phase is one where you test the depths of AI with your most difficult queries and are amazed by its ability to consolidate new and complex information.&nbsp; &nbsp; And then as you go deeper there is a moment when you get a strange answer or two. It may be a response &nbsp;that doesn’t match a previous one (this doctor is getting tired?). &nbsp;For me it came when I was asking ChatGpt for a reference and it gladly provided one. The problem was that paper never existed. It was completely fictitious! (the doctor needs a vacation!)<h3>The Problem with AI Hallucinations</h3>AI models like ChatGPT sometimes “hallucinate” due to the lack of guardrails. When pressured, they might guess answers to please us, which can be problematic in health decisions. There’s debate on this, with some <a data-mce-href="https://pubmed.ncbi.nlm.nih.gov/38182023/" href="https://pubmed.ncbi.nlm.nih.gov/38182023/" title="Do ChatGPT and Google differ in answers to commonly asked patient questions " target="_blank" rel="noopener">research</a> suggesting ChatGPT is a reliable resource, while <a data-mce-href="https://pubmed.ncbi.nlm.nih.gov/38353558/" href="https://pubmed.ncbi.nlm.nih.gov/38353558/" title="Usefulness and Accuracy of Artificial Intelligence Chatbot Responses to Patient Questions for Neurosurgical Procedures" target="_blank" rel="noopener">other studies</a> indicate it has room for improvement, particularly in healthcare education scenarios.&nbsp;<h2>Creating Maia: A Better AI Solution for Migraine Support</h2>As someone who has treated people with migraines for over 2 decades, &nbsp;I wanted to see if my observations above were shared other headache experts and if there was a better way to leverage AI to provide accurate and compassionate migraine support. To so, we set up two experiments; one on ChatGPT and another using a more focused version of migraine support AI developed by Wellkasa, called Maia - Migraine AI Assistant.<h3>Real-World Testing of Maia at Scripps Clinic</h3>In our first experiment, we asked a group of headache experts at Scripps Clinic to rate 14 different responses to common questions about migraine therapeutics, ranging from medications to procedures, to devices and lifestyle approaches. What we found was that ChatGPT did decently well in non-pharmacological therapy advice (rated on average above a 4 out of 5). It was not perfect here, though, and in some cases called an over-the-counter device as needing a prescription, which could alter how someone proceeds with a treatment. However, when it came to medications and procedures, ChatGPT was rated much lower (on average less than a 4 out of 5). The errors in this area, which is a fast-growing area with CGRP modulators and similar, were much more pronounced. The headache experts had many comments, including that ChatGPT:- Recommended outdated treatment options such as opioids.- Failed to note potential side effects and risks, especially in pregnancy.- Left out information on newer medications such as Nurtec and Qulipta, which were approved prior to ChatGPT 4.0 updates.So, based on these observations, it became clear that AI could do better. <h3>Maia - A Better Gen AI Migraine Support Solution</h3><figure id="figure-jmzessnjvlxc8h99e"><img id="jmzessnjvlxc8h99e" src="https://cdn.durable.co/blocks/2caz2BV6tQbfvDaBneskTHGlHoIEignz7jiLaEOzRhIYHb4y77wUVaUK2q5vFbEF.jpg" alt="Woman talking to AI in neuro setting" title="Woman talking to AI in neuro setting" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: center center;" data-corners="default" data-aspect="16:9" data-caption="" data-positionx="undefined" data-positiony="undefined" data-fullwidth="false" data-mce-src="https://cdn.durable.co/blocks/2caz2BV6tQbfvDaBneskTHGlHoIEignz7jiLaEOzRhIYHb4y77wUVaUK2q5vFbEF.jpg" data-mce-style="aspect-ratio: 16/9; object-position: center center;"></figure>Recognizing the issues with off the shelf broad Gen AI solutions like ChatGPT, I collaborated with the research team at Wellkasa to create a more focused AI Assistant for migraines called Maia. A key differentiating feature of Maia is a proprietary algorithm that scores each responses for accuracy of context validated by a clinician (myself in this case). Using this approach the team trained the AI model to more consistently provide the most accurate answer possible and avoid going over the guardrail to provide an answer that was false. For example, if Maia answered that Cefaly needed a prescription (false), she received a low score, and if she answered correctly that it didn’t, she would receive a high score. Over time, the AI model behind Maia was trained not only in simple true/false areas but also in more subtle lifestyle areas that can have many discrepancies, such as types of magnesium diets, stress management, etc. Over time, this model had responses ranked in all core migraine therapy areas, and as the responses became consistent and helpful and ready for our second experiment.Our second study introduced Maia to about 20 patients with migraines to try out for one week. The request was simple: Ask Maia some example questions related to migraine therapy, such as “what are available preventative migraine medications” or “what is a magnesium-rich breakfast,” and then pose any questions you can think of, either in a chat on MigraWell.com or a phone conversation (1 855 SAY MAIA). What we found is that patients not only found the responses helpful and something that they would share with a friend, but within one week of talking with Maia, they significantly increased their knowledge and confidence in pursuing migraine treatment in over 90% of core migraine areas.&nbsp;<h3>The Impact of Migraine Education</h3>These findings are key because we know that education on its own can improve migraine status as well as improving the level of benefit from a medication. Unfortunately, education can be time-consuming and not always personalized. However, with Maia, we found that migraine education can be simplified because learning about migraines becomes a very personal learning journey through simple and natural conversation. A person with migraine can "talk" to Maia in the language of their choice and discuss what they have in mind - just like they would with a friend. <h3>Future Directions &amp; Conclusion</h3>What we were also pleased with was that patients asked for features to be able to share this with their headache provider. While AI has been seen as a threat to clinicians, the more realistic likelihood is that patients want to engage their health professionals to get their opinion, especially in areas such as lifestyle that may be more nuanced. Our findings show that with proper training, Maia, a migraine chatbot, can be a valuable assistant to patients. We hope future research will confirm its benefits for clinicians as well.<h3>Sources</h3>&nbsp;1.<a data-mce-href="https://pubmed.ncbi.nlm.nih.gov/25159212/" href="https://pubmed.ncbi.nlm.nih.gov/25159212/" title="Effectiveness of Therapeutic Patient Education for Adults with Migraine" target="_blank" rel="noopener"> Kindelan-Calvo P et al. Effectiveness of Therapeutic Patient Education for Adults with Migraine. Pain Medicine. 2014;15(9):1619-1636.&nbsp;</a>&nbsp;2. <a data-mce-href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704417/" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704417/" title="Acceptability of AI-led chatbot services in healthcare" target="_blank" rel="noopener">Nadarzynski T et al. Acceptability of AI-led chatbot services in healthcare. Digital Health. 2019 Aug;5:2055207619871808.</a>

Why AI Can Be a Win for Migraine Patients – If Done Right!

Medical concept, stethoscope and medicine over the sackcloth written MIGRAINE.

Hi everyone, Dr. Bonakdar here. I'm thrilled to welcome you to the MigraWell blog!You might be wondering what sets MigraWell apart from other migraine websites? In a single phrase MigraWell is your:&nbsp;<blockquote>Personalized, research-backed migraine companion</blockquote>We built MigraWell based on research that asked a key question: what truly supports people with migraine? The answer [1] was individualized and holistic approach that addresses the overall impact of migraines, not just the headache itself.To achieve approach we created MigraWell with with focus on these core principles:<h2>Lifestyle and Integrative Health Focus:</h2>Medications are important, but managing stress, sleep, diet, and exercise is crucial. We offer clear, actionable advice to help you navigate these areas. <h2>Research-Driven Content:</h2>You'll find vetted information on effective treatments backed by science, not just testimonials. <h2>Personalized Conversational Support with (Maia):</h2><figure id="figure-uw1y0lu4tolwgmu4jn"><img id="uw1y0lu4tolwgmu4jn" src="https://cdn.durable.co/blocks/exlKWYHYHRxTwIgRqTbAcEGcbGoU8td9Te1TvZEQwG4WMH6fHGhtuPSccENzbLJc.png" alt="Maia - Migraine AI Assistant with a symbol of phone on top left" title="Maia - Migraine AI Assistant with a symbol of phone on top left" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 3/2; object-position: 50% 5%;" data-corners="default" data-aspect="3:2" data-caption="Maia - Migraine AI Assistant" data-positionx="50%" data-positiony="5%" data-fullwidth="false" data-mce-src="https://cdn.durable.co/blocks/exlKWYHYHRxTwIgRqTbAcEGcbGoU8td9Te1TvZEQwG4WMH6fHGhtuPSccENzbLJc.png" data-mce-style="aspect-ratio: 3/2; object-position: 50% 5%;"><figcaption class="body-normal text-gray-500 mt-2">Maia - Migraine AI Assistant</figcaption></figure>Generic advice can only go so far. Maia, our Migraine AI assistant, provides immediate and personalized answers to your specific migraine questions. Whether you're looking for a magnesium-rich breakfast recipe or tips to improve sleep, just talk to Maia. In a recent study at Scripps Health in San Diego CA, Maia significantly improved patients' knowledge and confidence in managing their migraines within just one week. The results from this study will be highlighted the 2024 American Headache Society 66th Annual Scientific Meeting. <h2>Empowering the Clinician-Patient Conversation:</h2><figure id="figure-ocd6a5v1ialwgmytlu"><img id="ocd6a5v1ialwgmytlu" src="https://cdn.durable.co/shutterstock/7lF96itx7gn32LwzMZkndYu7GFypEKJpDr2LIbXWroRunffOt31w9OJZ5Ap7BO8h.jpeg" alt="Young female patient listening to her doctor." title="Young female patient listening to her doctor." class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: center center;" data-corners="default" data-aspect="16:9" data-caption="" data-positionx="undefined" data-positiony="undefined" data-fullwidth="false" data-mce-src="https://cdn.durable.co/shutterstock/7lF96itx7gn32LwzMZkndYu7GFypEKJpDr2LIbXWroRunffOt31w9OJZ5Ap7BO8h.jpeg" data-mce-style="aspect-ratio: 16/9; object-position: center center;"></figure>We want to help you collaborate with your doctor to explore treatment options. We enable you to do so by offering latest research backed educational content from migraine symptoms and triggers to medications, devices and lifestyle interventions. Most importantly, we deliver this information in simple and personalized format through Maia. We encourage you to engage with Maia before you see your clinician. Maia can help you cover the basics and prepare you for your consult. After your consult, Maia can also support you by helping you understand the details of your treatment plan and next steps. &nbsp;<h2>Why this approach?</h2>A 2023 Mayo Clinic study [1] examined patient perspectives on migraine treatment. The findings highlighted the importance of an individualized and holistic approach that addresses the overall impact of migraines, not just the headache itself. Patients expressed a preference for treatments that are:Non-pharmacological. Highly effective. Fast-acting. Long-lasting. Affordable and accessible. Self-managed for greater autonomy. A combination of acute and preventive options. The study also revealed key aspects desired during discussions with healthcare professionals:Sharing knowledge and exploring various treatment options. Trust in healthcare providers. Clear communication, especially for complex treatments. A respectful and validating approach. Shared decision-making. These results align with what I've observed in my 20+ years of treating migraines and echo the following conclusion:<blockquote>Patients want to be active participants in their care and learn about all their options, particularly non-pharmaceutical and self-care strategies. </blockquote>While clinicians support this approach, our current system often lacks the tools to fully address these needs. Here's why:Discussing and incorporating lifestyle topics like diet, stress management, and exercise can be time-consuming.Clinicians may not feel fully equipped to provide detailed guidance in these areas, leaving patients to navigate them independently. Unfortunately, much of the online information available is either not scientifically vetted or contradictory, making it difficult to find safe and effective guidance. MigraWell aims to bridge this gap by integrating wellness into migraine treatment in a way that's both scientific and individualized, and practical for both patients and clinicians. We'll help you answer questions about and incorporate treatments you're considering, especially non-pharmacological and lifestyle therapies. We'll also help you connect these options with your care team to facilitate shared decision-making.We hope MigraWell becomes your trusted partner on your migraine journey. We understand that everyone's path is unique. Having access to reliable information, especially information you can share with your doctor, is a key part of achieving the comprehensive migraine management you deserve.In the coming months, this blog will delve into new migraine management topics and explore important lifestyle questions with clear and actionable answers. We look forward to hearing your thoughts as we embark on this journey together.Yours in Health,Dr. Bonakdar [1] <a data-mce-href="https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.14430" href="https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.14430">Urtecho M, Wagner B, Wang Z, et al. A qualitative evidence synthesis of patient perspectives on migraine treatment features and outcomes. Headache: The Journal of Head and Face Pain. 2023;63(2):185-201. doi:10.1111/head.14430&nbsp;</a>

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Maia Recognized at American Headache Society & Medscape

Why AI Can Be a Win for Migraine Patients – If Done Right!

MigraWell: A Different Approach to Migraine Education and...