Validity and Reliability of the Arabic Adapted Version of the DN4 Questionnaire (<i>Douleur Neuropathique 4 Questions</i>) for Differential Diagnosis of Pain Syndromes with a Neuropathic or Somatic Component

Harifi, G.; Ouilki, I.; Bouchti, I. El; Ouazar, M. Ait; Belkhou, A.; Younsi, R.; Amine, Mohamed; Tazi, Illias; Abouqal, Rédouane; Niamane, R.; Hassani, S. El

doi:10.1111/j.1533-2500.2010.00399.x

Cited by 42 publications

(54 citation statements)

References 14 publications

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“…In order to identify neuropathic characteristics of the pain, the participants were asked 10 questions from the Arabic version of the DN4 31. The DN4 was originally developed and used to identify and classify neuropathic pain 32.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence of chronic pain with neuropathic characteristics: a randomized telephone survey among medical center patients in Kuwait

Zghoul

Ross

Edwards

et al. 2017

JPR

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BackgroundChronic pain with neuropathic characteristics is considered to be an international health problem. However, surveys on the actual incidence of neuropathic pain have not been conducted in many Middle East countries, including Kuwait. The aim of this study was to examine the incidence of pain and medical comorbidities among a random sample of patients treated at a large medical center in Kuwait.MethodsA list of 1,000 patients was created from the hospital medical record system, and a telephone survey was conducted on 759 patients who responded to the phone call, of which 67.2% (N=510) participated. Those who stated that they had pain every day for the past 3 months were invited to answer additional questions about their pain.ResultsFifty-six percentage of those surveyed (N=283) reported experiencing chronic pain. Total average age was 49.2 years (SD=14.5), 45.5% were female, and 70.5% were Kuwaiti nationals. Most (74.3%) reported having diabetes and one-third (32.2%) showed evidence of neuropathic pain characteristics (mean DN4=2.8, SD=1.7). Other comorbid medical conditions were prevalent (48.4% hypertension, 30.4% arthritis, 22.6% heart disease, and 20.4% asthma) with an average of 2.3 (SD=1.3) medical problems per person. Those with pain tended to be older, female, unemployed, and overweight (p<0.01). The pain was mostly located in the lower extremities and those with neuropathic pain tended to report a higher intensity of pain and a higher frequency of seeking treatment for their pain in a clinic or hospital (p<0.05). Most relied on over-the-counter medications for their pain (38.1%). Very few were taking prescription medication for their pain.ConclusionThis survey suggests that chronic pain is more prevalent in a medical population in Kuwait than previously anticipated. Health care services and behavioral interventions to improve lifestyle changes in Kuwait and other Arab countries are needed to positively impact pain and reduce other comorbidities.

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Section: Methodsmentioning

confidence: 99%

“…A score of <4 suggests that the pain is unlikely to be neuropathic. The DN4-interview questionnaire has been shown to have 83% sensitivity and 90% specificity when compared to clinical diagnosis 31. In persons with diabetes, the DN4 showed a high diagnostic accuracy for neuropathic pain.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of chronic pain with neuropathic characteristics: a randomized telephone survey among medical center patients in Kuwait

Zghoul

Ross

Edwards

et al. 2017

JPR

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“…[56] To the best of our knowledge, DN4 has already been psychometrically validated in the Moroccan Arabic dialect. [7] However, as residents of other Arab countries do not readily understand this dialect, it is almost impossible to administer the Moroccan Arabic version of the DN4 among patients in residing in other Arab locations.…”

Section: Introductionmentioning

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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“…Waist circumference (m) was measured [36]. Neurological exam and ''douleur neuropathique 4 questions'' (DN4) score [37] were conducted in order to assess diabetic neuropathy. Two groups were identified [0.…”

Section: Physical Examinationmentioning

confidence: 99%

Lung function in poorly controlled type 1 North African diabetic patients: A case-control study

Slim

Khalaf

Latiri

et al. 2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Aim: To compare the lung function parameters of poorly controlled type-1-diabetesmellitus (T1DM) patients with age-; height and sex-matched healthy-non-smokers (HNS).Population and methods: Subjects aged 35-60 Yrs who have a poorly controlled T1DM (glycated-Haemoglobin level >7%) with a disease history of more than 10 Yrs (n = 14) and HNS subjects (n = 14) were recruited. Clinical, anthropometric and fasting biological data were This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Aging; Case-control study collected. Plethysmographic data (flows, volumes, estimated-lung-age (ELA), lung-capacity-totransfer-carbon-monoxide (DLCO)) were measured. Large-airway-obstructive-ventilatory-defect (LAOVD) was defined as first-second-forced-expiratory-volume (FEV 1 )/forced-vital-capacity (FVC) below the lower-limit-of-normal (LLN). Restrictive-ventilatory-defect (RVD) was defined as total-lung-capacity (TLC) < LLN. Lung-hyperinflation was defined as residual-volume (RV) > upper-limit-of-normal. Student t-test and chi-2 test were used to compare plethysmographic data and profiles of the two groups.Results: The two groups were matched in chronological-lung-age (CLA) (respectively 47 ± 7 vs. 50 ± 8 Yrs) and sex (7 males and 7 females in each group) and height. Compared to the HNS group, the T1DM one had significantly lower FEV 1 , FVC, slow-vital-capacity and maximal-midexpiratory-flow (respectively 99 ± 11% vs. 83 ± 11%, 99 ± 9% vs. 86 ± 11%, 80 ± 8% vs. 67 ± 15% and 98 ± 23% vs. 72 ± 23%), had significantly higher TLC and RV (respectively, 105 ± 20% vs. 123 ± 24% and 108 ± 22% vs. 131 ± 24%) and had significantly higher percentage of subjects with lung-hyperinflation (7.1% vs. 43.0%). Both groups had similar percentages of LAOVD and RVD and similar corrected DLCO values. ELA of the T1DM group (57 ± 10 Yrs) was significantly higher than CLA.Conclusion: Poorly controlled T1DM seems to alter ventilatory mechanics without effect on the alveolo-capillary-membrane. In addition, it accelerates the respiratory ageing.

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Validity and Reliability of the Arabic Adapted Version of the DN4 Questionnaire (Douleur Neuropathique 4 Questions) for Differential Diagnosis of Pain Syndromes with a Neuropathic or Somatic Component

Abstract: This study represents the second validation DN4 in a language different from the original after the Spanish adaptation. These results support the high discriminatory value of the DN4 questionnaire for identification of NP.

Cited by 42 publications

References 14 publications

Prevalence of chronic pain with neuropathic characteristics: a randomized telephone survey among medical center patients in Kuwait

Prevalence of chronic pain with neuropathic characteristics: a randomized telephone survey among medical center patients in Kuwait

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

Lung function in poorly controlled type 1 North African diabetic patients: A case-control study

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