POUND (migraine likelihood)
POUND mnemonic (Detsky 2006): a 0-5 count of migraine features (Pulsatile, 4-72 hours, Unilateral, Nausea, Disabling); 4 or more strongly favors migraine.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Pulsatile / throbbing
- Yes
- Duration 4-72 hours
- Yes
- Unilateral
- Yes
- Nausea or vomiting
- Yes
Result: POUND 4/5: 4 or more features strongly favor migraine (likelihood ratio about 24).
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Features
- Pulsatile, hOurs (4-72 h), Unilateral, Nausea/vomiting, Disabling; count 0-5.
- Likelihood
- likelihood ratio for migraine ~24 with 4 or more features, ~3.5 with exactly 3, and ~0.41 with 2 or fewer.
What you enter
- Pulsatile / throbbing
- Duration 4-72 hours
- Unilateral
- Nausea or vomiting
- Disabling intensity
How this is calculated
Detsky ME, McDonald DR, Baerlocher MO, Tomlinson GA, McCrory DC, Booth CM. Does this patient with headache have a migraine or need neuroimaging? JAMA. 2006;296(10):1274-1283. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.