Hindi version of short form of douleur neuropathique 4 (S-DN4) questionnaire for assessment of neuropathic pain component: a cross-cultural validation study

Abstract

BackgroundPain with neuropathic characteristics is generally more severe and associated with a lower quality of life compared to nociceptive pain (NcP). Short form of the Douleur Neuropathique en 4 Questions (S-DN4) is one of the most used and reliable screening questionnaires and is reported to have good diagnostic properties. This study was aimed to cross-culturally validate the Hindi version of the S-DN4 in patients with various chronic pain conditions.MethodsThe S-DN4 is already translated into the Hindi language by Mapi Research Trust. This study assessed the psychometric properties of the Hindi version of the S-DN4 including internal consistency and test-retest reliability after 3 days' post-baseline assessment. Diagnostic performance was also assessed.ResultsOne hundred sixty patients with chronic pain, 80 each in the neuropathic pain (NeP) present and NeP absent groups, were recruited. Patients with NeP present reported significantly higher S-DN4 scores in comparison to patients in the NeP absent group (mean (SD), 4.7 (1.7) vs. 1.8 (1.6), P < 0.01). The S-DN4 was found to have an AUC of 0.88 with adequate internal consistency (Cronbach's α = 0.80) and a test-retest reliability (ICC = 0.92) with an optimal cut-off value of 3 (Youden's index = 0.66, sensitivity and specificity of 88.7% and 77.5%). The diagnostic concordance rate between clinician diagnosis and the S-DN4 questionnaire was 83.1% (kappa = 0.66).ConclusionsOverall, the Hindi version of the S-DN4 has good internal consistency and test-retest reliability along with good diagnostic accuracy.

Nepalese version of Douleur Neuropathique 4 (DN4) questionnaire for Assessment of Neuropathic pain: A Validation Study

“…The sensitivity and specificity of our version of the questionnaire were 75% and 95.3%, respectively, for test 1, and 76.2% and 98.8%, respectively, for test 2, which were the highest at the cut-off value 4 or more. This finding is in accordance with most of the validation studies (7,9,11). There are, however, validations done in Dutch (23) and New Arabic (22) languages, and both found the cutoff value at 5/10.…”

“…Based on our study, the most frequent complaints that patients with neuropathic pain had were burning pain, electrical sensation, tingling sensation, and numbness. When this is compared with other studies, we found variations (7,22,23). We believe that neuropathic pain consists of a collection of symptoms and signs that may also depend on the type of disease, so rather than focusing on any specific item for predicting neuropathic pain, one must consider the cutoff value.…”

“…For this reason, caution must be exercised while asking the patient about cold pain. In the Hindi version of DN4 questionnaire also, cold pain was present in only 14% of patients with neuropathic pain (7). In our study, only 17 % of patients with neuropathic pain had symptoms of cold pain.…”

“…Due to its popularity, the DN4 questionnaire has been translated and validated into various languages such as Hindi (7), Thai (8), Japanese (9), Korean (10), Spanish (11), Greek (12), Portuguese (13), Turkish (14) and so on. It was originally developed by French Neuropathic pain group in 2005 (15).…”

Validation of Complete Hindi Version of Douleur Neuropathique 4 Questionnaire for Assessment of Neuropathic Pain

“…[9][10][11][12][13][14][15][16] e original French version of DN4 questionnaire has very good sensitivity (83%) and specificity (90%) for the identification of chronic NP as a consequence of a lesion or disease of the nervous system (either peripheral or central). [3] Various researchers, including Bouhassira et al [3] and Gudala et al, [17] have validated an interview version of the DN4 or Short form of DN4 including only 7 self-completing items on various NeP symptoms and not the whole 10 items. e reason for pursuing the short form and not the complete DN4 was the ease and lack of manpower and time by both the studies.…”