Conference Coverage

New App Aims to Bring Personalized Headache Medicine One Step Closer

Headache specialists design an app that can to identify headache types and help patients manage and improve their headaches.


STANFORD, CA—Headache specialists have created a new app intended to support patients with headache pain. Developed by board-certified headache specialists in collaboration with a machine learning and artificial intelligence professional, the BonTriage Headache Compass may help patients with headache better manage and improve their condition. When used consistently over time, this app is intended to help patients reduce the frequency, severity, and duration of headaches, as well as the disability they cause.

“The BonTriage Headache Compass provides a diagnostic clinical impression and monitoring, which patients can take to their doctor or just use to gain insight into their condition,” said Robert Cowan, MD, Professor of Neurology and Chief of the Division of Headache Medicine at Stanford University and a co-creator of the new app.

Robert Cowan, MD

The app is designed to generate a visualization of the user’s headache and compare it to the typical clinical case of that condition to see whether there are any similarities or differences (see Figure). The compass automatically updates as the user enters more information and will warn users if the information added is insufficient to make a confident conclusion. Users also can compare headache characteristics among their own headaches or across typical headache types.

Personalized Data

The BonTriage Headache Compass app is the second product developed by BonTriage. The first is a detailed web-based questionnaire, available at, that creates a detailed report about a patient’s headache. The questionnaire has been validated and its accuracy is greater than 90%. Once completed, the questionnaire can be printed and shared with the patient’s physician.

The app works together with the questionnaire, but can be used independently. “When you first download the app, it asks the questions that are necessary to make the diagnostic clinical impression,” Dr. Cowan said. After asking basic demographic questions, the app poses specific questions about the characteristics of typical and current headaches and other related conditions. This information, which takes about 10 minutes to enter, will populate the app and generate a clinical impression similar to one formed at an initial clinical presentation.

The BonTriage Headache Compass then prompts users daily for data on headaches, medications, triggers, and lifestyle factors. Based on these data, the app can predict headache frequency; report the effect of treatment strategies on headache frequency, severity, and duration in real time; and answer questions based on personalized data. Users can thus see potential connections between their headaches, triggers, and behaviors. Data entry requires a minute or two each day.

The top compass depicts the characteristics of the user's headache, based on personal information entered into the app. The bottom compass illustrates the typical symptoms and characteristics of a specific headache type, in this case chronic migraine.

“Every headache patient is different, owning their own symptoms and triggers. That is why we first analyze [a patient’s] symptoms to identify [his or her] probable headache type and generate a personalized analysis,” said Alan Rapoport, MD, Professor of Neurology at the David Geffen School of Medicine at the University of California, Los Angeles, and a co-creator of the app. “Data personalized to the user’s unique headache problems allow patients to partner with their doctors and share decision making and care planning, which leads to much better outcomes,” said Dr. Rapoport.

Individualized Advice

The app’s internal analytics analyze data to interpret the personalized information that it collects. This analysis is intended to help patients with headache avoid factors (behaviors, triggers, etc) that worsen their headaches and enhance behaviors that reduce their headaches. The app also provides feedback to indicate which management strategies are working. “One critical piece of information we want to feed back to patients is whether they are getting better or not, based on how they are treating their headaches,” said Dr. Cowan. The data that the BonTriage Headache Compass app collects can inform patients about their specific headache triggers, lifestyle choices, medication, or environmental factors, and about how they influence their headache. After a month of consistent data entry … the app can begin to predict headaches. With continued use, the app could, for example, send a text message advising the user that a storm is coming to their area and he orshe did not sleep well the night before, so he or she should skip wine with dinner because of an increased risk of headache on that particular night.

Alan Rapoport, MD

Users of the BonTriage Headache Compass can query the app for data on areas of personal concern. For example, it can compare headache severity or frequency between months or examine the relationship between exercise or sleep and headache duration or frequency. The Headache Compass tool can provide visual representations and headache indices (ie, scores) to compare a current headache with previous headaches.

The BonTriage Headache Compass is available for free in the iPhone App Store.

Glenn S. Williams

Next Article: