HIT-6 Score Calculator

Headache Impact Test — Measures how headaches affect your daily functioning and quality of life

Updated April 4, 2026 4-week recall6 questions~2 minutes

Instructions

Answer each question based on the past 4 weeks. The official HIT-6 score is only calculated once all 6 questions are answered.

Response options and point values
Never
6 pts
Rarely
8 pts
Sometimes
10 pts
Very Often
11 pts
Always
13 pts
0 of 6 questions answered
1
Pain severity

When you have headaches, how often is the pain severe?

2
Role functioning

How often do headaches limit your ability to do usual daily activities including household work, work, school, or social activities?

3
Rest need

When you have a headache, how often do you wish you could lie down?

4
Fatigue

In the past 4 weeks, how often have you felt too tired to do work or daily activities because of your headaches?

5
Emotional impact

In the past 4 weeks, how often have you felt fed up or irritated because of your headaches?

6
Concentration

In the past 4 weeks, how often did headaches limit your ability to concentrate on work or daily activities?

Recent saved HIT-6 results

Saved HIT-6 results are synced to your account and also appear in your dashboard.

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What is the HIT-6?

The Headache Impact Test (HIT-6) is a validated patient-reported outcome measure that assesses the impact of headaches on daily functioning and quality of life. Unlike the MIDAS which counts lost days, HIT-6 measures the severity of impact across multiple life domains.

The HIT-6 evaluates six key areas: pain severity, role functioning, vitality, cognitive functioning, and psychological distress. This comprehensive approach helps clinicians understand how headaches affect patients beyond just the number of attacks.

How HIT-6 Scoring Works

Each of the 6 questions has 5 response options, scored from 6 points (Never) to 13 points (Always). The total score ranges from 36 to 78, with higher scores indicating greater headache impact.

Never (6)
Rarely (8)
Sometimes (10)
Very Often (11)
Always (13)

Total Score = Sum of all 6 answers (Range: 36-78)

HIT-6 vs MIDAS: When to Use Each

HIT-6MIDAS
Time PeriodPast 4 weeksPast 3 months
What It MeasuresImpact severityDays lost/reduced
Best ForMonthly monitoringQuarterly assessment
SensitivityDetects subtle changesBetter for severe cases

Both tools provide complementary information. Using both gives a more complete picture of headache burden.

Clinically Meaningful Change

HIT-6 is useful for tracking change over time, but one universal threshold should not be applied to every situation. Smaller changes can matter, especially near a patient's baseline, while larger shifts are often easier to interpret. Use score changes alongside headache frequency, diary patterns, treatment changes, and other validated tools.

Clinical Note

When to See a Doctor About Your HIT-6 Score

If your HIT-6 score is 60 or higher (severe impact), or if headaches are clearly worsening, clinical review is reasonable. Seek medical attention promptly if you experience:

  • Headaches that are progressively worsening in severity or frequency
  • Aura symptoms lasting longer than 60 minutes
  • New neurological symptoms (weakness, numbness, speech difficulty)
  • Headaches not responding to over-the-counter medication
  • Headaches significantly impacting work, relationships, or mental health

Related Migraine Assessment Tools

Frequently Asked Questions

What is a normal HIT-6 score?

A HIT-6 score of 49 or less indicates little to no impact from headaches on daily life. Scores between 50-55 suggest some impact, 56-59 indicate substantial impact, and 60 or higher represents severe impact. The minimum possible score is 36, and the maximum is 78.

How is HIT-6 different from MIDAS?

HIT-6 measures the overall impact of headaches across 6 dimensions (pain, functioning, vitality, cognitive, emotional, social) over 4 weeks. MIDAS specifically measures disability (days lost or reduced productivity) over 3 months. HIT-6 provides a broader picture of headache impact, while MIDAS focuses on quantifiable productivity loss.

How often should I take the HIT-6 test?

The HIT-6 uses a 4-week recall window, so monthly or treatment-change comparisons are often the most practical way to use it.

What does a HIT-6 score of 60+ mean?

A score of 60 or higher falls in the severe-impact band. It reflects a high reported burden, but it does not automatically dictate one specific treatment plan by itself.

Can I use HIT-6 to track treatment progress?

Yes. HIT-6 is useful for tracking impact over time, but score changes should be interpreted with clinical context, baseline severity, and other validated measures such as MIDAS.

Is the HIT-6 questionnaire validated?

Yes, the HIT-6 has been extensively validated in clinical studies. It was developed from the longer 54-item Headache Impact Test and has demonstrated reliability and validity across diverse populations. It's used worldwide in clinical practice and research.

Why do HIT-6 and MIDAS sometimes give different results?

HIT-6 and MIDAS measure different aspects of headache burden. Someone might have severe pain (high HIT-6) but rarely miss work (low MIDAS), or vice versa. Using both tests provides a comprehensive picture. HIT-6 captures intensity and emotional impact; MIDAS captures productivity loss.

What should I bring to my doctor about my HIT-6 score?

Bring your HIT-6 score along with: 1) how it has changed over time, 2) your current treatments, 3) headache frequency, and 4) any patterns you've noticed. Our calculator provides a downloadable summary you can use for that discussion.

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References

1. Kosinski M, Bayliss MS, Bjorner JB, et al. A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res. 2003;12(8):963-974.

2. Yang M, Rendas-Baum R, Varon SF, Kosinski M. Validation of the Headache Impact Test (HIT-6) across episodic and chronic migraine. Cephalalgia. 2011;31(3):357-367.

3. Smelt AFH, Assendelft WJJ, Terwee CB, Ferrari MD, Blom JW. What is a clinically relevant change on the HIT-6 questionnaire? Cephalalgia. 2014;34(1):29-36.

Medical Disclaimer: This tool uses the published HIT-6 question set and official scoring weights. Interpretation of score changes depends on the clinical setting, baseline severity, and why you are retesting. Discuss results with your healthcare provider.