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Validation of a New Arabic Version of the Neuropathic Pain Diagnostic Questionnaire (DN4)
Author(s) -
Chatila Nadwa,
Pereira Bruno,
Maarrawi Joseph,
Dallel Radhouane
Publication year - 2017
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12419
Subject(s) - neuropathic pain , medicine , receiver operating characteristic , intraclass correlation , kappa , arabic , physical therapy , neuralgia , psychometrics , mathematics , anesthesia , clinical psychology , linguistics , philosophy , geometry
The “Douleur Neuropathique 4 ( DN 4) questionnaire” was developed for screening neuropathic pain. The purpose of this work was to validate the DN 4 questionnaire in the standard Arabic language. First, the questionnaire was translated and semantically adapted to Arabic according to the international guidelines for cross‐cultural adaptation. Second, a prospective observational study was performed to validate this questionnaire. A total of 195 patients with chronic pain ( n = 99 with neuropathic pain and n = 96 without neuropathic pain) were enrolled in the study. The internal consistency Kuder–Richardson's Formula 20 for the whole DN 4 questionnaire was 0.86 ( P < 0.001) and the intraclass correlation coefficient 0.99 (95% CI : 0.99 to 1.00). The test–retest reliability kappa coefficient for each item ranged from 0.92 to 1.00. Using a receiver‐operating characteristic ( ROC ) curve analysis, the areas under the curve were 0.94 and 0.97 for the 7‐item DN 4 and 10‐item DN 4, respectively. A cut‐off score of 3 resulted in a sensitivity of 97.0% and a specificity of 82.3% for the 7‐item DN 4, while a cut‐off score of 5 for the 10‐item DN 4 resulted in a sensitivity of 93.0% and a specificity of 95.8%. Tingling, numbness, and hypoesthesia to touch and to pricking were the most discriminating pain items. The sensitivity and specificity of the 7‐item DN 4 and 10‐item DN 4 were not influenced by either pain severity or educational level. In conclusion, this new Arabic version DN 4 questionnaire is a simple, reliable, and valid tool for discriminating between neuropathic and non‐neuropathic pain. It represents a useful tool in clinical setting and population‐based studies.