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Diagnostic accuracy of two questionnaires for the detection of neuropathic pain in the S panish population
Author(s) -
Hamdan A.,
Luna J.D.,
Del Pozo E.,
Gálvez R.
Publication year - 2014
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/j.1532-2149.2013.00350.x
Subject(s) - neuropathic pain , medicine , population , anesthesia , environmental health
Background Several questionnaires have been developed for the detection of neuropathic pain. Objectives This study aimed to compare the diagnostic accuracy of the L eeds A ssessment of N europathic S ymptoms and S igns ( LANSS ) pain scale and the D ouleur N europathique en 4 questions ( DN 4) questionnaire for the detection of peripheral neuropathic pain in the S panish population, and to analyse in detail the diagnostic quality of each item in these questionnaires. Methods A total of 192 patients were enrolled. We compared the validity of the DN 4 and LANSS questionnaires by studying sensitivity and specificity and using receiver operating characteristic ( ROC ) curve analysis. We also analysed the validity of each item in the questionnaires. Results The sensitivity of the DN 4 questionnaire with an accepted cut‐off value of ≥4 was 95.04% and that of the LANSS questionnaire with an accepted cut‐off value of ≥12 was 80.17%. The specificity of the DN 4 instrument was 97.18% and that of the LANSS instrument was 100%. The estimated area under the ROC curve (95% confidence interval) was 0.989 (0.977–1) for the DN 4 instrument and 0.973 (0.956–0.991) for the LANSS questionnaire. The area under the ROC curve was significantly larger for the DN 4 than the LANSS questionnaire ( p < 0.05). Analyses of specific items showed that tingling and numbness in the DN 4 tool, and light touch pain and altered pinprick threshold in the LANSS scale, were the most important features of neuropathic pain. Conclusions These results show that although both questionnaires are good screening tools, the DN 4 questionnaire is particularly recommended for identifying patients with neuropathic pain in clinical practice and research studies.