Validation of the Greek Version of the <scp>DN</scp>4 Diagnostic Questionnaire for Neuropathic Pain

Sykioti, Panagiota; Zis, Panagiotis; Vadalouca, Athina; Siafaka, Ioanna; Αrgyra, Eriphili; Bouhassira, Didier; Stavropoulou, Evmorfia; Karandreas, Nikolaos

doi:10.1111/papr.12221

Cited by 38 publications

(50 citation statements)

References 22 publications

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“…For the 10‐item DN4, our findings slightly differ from those in studies in other languages. We found a cut‐off point of 5/10, similar to that of the Dutch version, while the other versions established their cut‐off point at 4/10 . These differences might reflect linguistic specificities and cultural differences, but they may also result from methodological variations between studies: differences in the clinical characteristic of patients, the method to diagnose neuropathic pain, the method to fill in the questionnaire (clinician‐administered questionnaire, self‐administered questionnaire, phone questionnaire).…”

Section: Discussionmentioning

confidence: 52%

Validation of a New Arabic Version of the Neuropathic Pain Diagnostic Questionnaire (DN4)

et al. 2016

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The "Douleur Neuropathique 4 (DN4) questionnaire" was developed for screening neuropathic pain. The purpose of this work was to validate the DN4 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 DN4 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 DN4 and 10-item DN4, respectively. A cut-off score of 3 resulted in a sensitivity of 97.0% and a specificity of 82.3% for the 7-item DN4, while a cut-off score of 5 for the 10-item DN4 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 DN4 and 10-item DN4 were not influenced by either pain severity or educational level. In conclusion, this new Arabic version DN4 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.

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Section: Discussionmentioning

confidence: 52%

Validation of a New Arabic Version of the Neuropathic Pain Diagnostic Questionnaire (DN4)

et al. 2016

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“…[21] The DN4, which takes into account symptoms indicative of NP, is specifically designed to assess NP. The DN4 questionnaire was translated in many languages including Greek,[22] Portuguese,[23] and Spanish. [24]…”

Section: Discussionmentioning

confidence: 99%

Development and validation of Arabic version of the douleur neuropathique 4 questionnaire

et al. 2017

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Introduction:The douleur neuropathique 4 (DN4) questionnaire is a widely used tool for diagnosis of neuropathic pain (NP). The aim was to translate, culturally adapt, and validate the DN4 questionnaire in Arabic.Methods:A systematic translation process was used to translate the original English DN4 into Arabic. After the pilot study, the Arabic version was validated among patients with chronic pain in two tertiary care centers. The reliability of the translated version was examined using internal consistency, test-retest reliability, and intraclass correlation coefficients. We examined the validity of the Arabic DN4 via construct validity, concurrent validity (associations with the numeric rating scale, brief pain inventory, and Self-Completed Leeds Assessment of Neuropathic Symptoms and Signs [S-LANSS]), face validity, and diagnostic validity. To investigate the responsiveness, the translated DN4 was administered twice among the same group of patients.Results:A total of 142 subjects (68 men, 74 women) were included in the study. Cronbach's α was 0.67 (95% confidence interval [CI]: 0.59–0.75), and interclass correlation coefficients was 0.81 (95% CI: 0.76–0.87). The DN4 was moderately associated with the S-LANSS questionnaire. Results showed our Arabic DN4 to have good diagnostic accuracy, with area under the curve of 0.88 (95% CI: 0.82–0.94). As with the original version, a score of ≥4 was found to be the best cut-off for the diagnosis of NP, with a sensitivity of 88.31%, specificity of 74.47%, a positive predictive value of 85%, and a negative predictive value of 80%. Most patients found the DN4 questionnaire to be clear and easy to understand, and thought the questionnaire items covered all their problem areas regarding their pain.Conclusion:Our Arabic version of the DN4 is a reliable and valid screening tool that can be easily administered among patients to differentiate between NP and non-NP.

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“…However, in some cases due to maladaptive pain responses and neuroplasticity, there is peripheral or central sensitization of the nociceptive pathways leading to neuropathic pain, which is chronic, unexplained by signs or history, and accompanied by one or more of the following features: hyperalgesia, allodynia, spontaneous pain, dysesthesia, burning, and irritation. 45–48 Given the importance of distinguishing neuropathic pain from physiological nociceptive pain, numerous questionnaires have been developed and validated to screen for non-ocular neuropathic pain: Neuropathic Pain Symptom Inventory, NPSI; 49–52 Leeds Assessment of Neuropathic Symptoms and Signs, LANSS; 53–56 Neuropathic Pain Questionnaire, NPQ; DN4 Pain; 57–61 painDETECT; 62–67 and ID Pain. 68–70 Subtypes of neuropathic pain can also be detected using the modified Neuropathic Pain Symptom Inventory in German, NPSI-G. 71 Recently, seve ghlighted the role of neuropathic pain in patients with chronic dry eye-like pain.…”

Section: Discussionmentioning

confidence: 99%

Validity and Reliability of a Novel Ocular Pain Assessment Survey (OPAS) in Quantifying and Monitoring Corneal and Ocular Surface Pain

et al. 2016

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Purpose To validate the Ocular Pain Assessment Survey (OPAS), specifically designed to measure ocular pain and quality of life for use by eye care practitioners and researchers. Design A single-center, cohort study was conducted in patients with and without corneal and ocular surface pain at initial and follow-up visits over a 6-month period. The content of the OPAS was guided by literature review, a body of experts, and incorporating conceptual frameworks from existing pain questionnaires. The Wong-Baker FACES® Pain Rating Scale served as the gold standard for measuring intensity of ocular pain. Subjects 102 patients aged 18 to 80 years completed the OPAS at the initial visit. 21 patients were followed up post-treatment. Methods and Statistical Analysis Indices of validity and internal consistency (Spearman’s rank-order, rs, or Pearson’s correlation coefficients, rp), and coefficient of reliability (Cronbach’s α) were determined in addition to equivalence testing, exploratory factor analysis (EFA) and diagnostic analysis. Main outcome measures Eye pain intensity was the primary outcome measure, while interference with quality of life (QoL), aggravating factors, associated factors, associated non-eye pain intensity and self-reported symptomatic relief were the secondary outcome measures. Results The OPAS had criterion validity at both initial (rs= 0.71, n= 102, P<0.01) and follow-up visits (rs= 0.97, n= 21, P<0.01). Equivalence tests yielded OPAS and gold standard equivalence for both the initial and follow-up visits. EFA supported 6 sub-scales (eye pain intensity 24 h and 2 weeks, non-eye pain intensity, quality of life, aggravating factors, and associated factors) confirming multi-dimensionality. Cronbach’s α >0.83 for all sub-scales established strong internal consistency, which correlated with the gold standard, including 24-hour eye pain intensity and QoL interference scores (rp = 0.81, 0.64, P< 0.001). At follow-up, reduction in pain scores was accompanied by improvement in all dimensions of the OPAS. Percent change in QoL correlated to percent change in the gold standard (rp = 0.53, P<0.05). The OPAS was sensitive (94%), specific (81%) and accurate (91%) with a diagnostic odds ratio greater than 50. Conclusions The OPAS is a valid, reliable and responsive tool with strong psychometric and diagnostic properties in the multi-dimensional quantification of corneal and ocular surface pain intensity, and quality of life.

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Validation of the Greek Version of the DN4 Diagnostic Questionnaire for Neuropathic Pain

Abstract: The Greek version of DN4 is a valid tool for discriminating between neuropathic and nociceptive pain conditions in daily practice.

Cited by 38 publications

References 22 publications

Validation of a New Arabic Version of the Neuropathic Pain Diagnostic Questionnaire (DN4)

Validation of a New Arabic Version of the Neuropathic Pain Diagnostic Questionnaire (DN4)

Development and validation of Arabic version of the douleur neuropathique 4 questionnaire

Validity and Reliability of a Novel Ocular Pain Assessment Survey (OPAS) in Quantifying and Monitoring Corneal and Ocular Surface Pain

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