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Investigating the validity of the DN4 in a consecutive population of patients with chronic pain

Hans Timmerman, Monique A H Steegers, Frank J P M Huygen, Jelle J Goeman, Nick T van Dasselaar, Marcel J Schenkels, Oliver H G Wilder-Smith, André P Wolff and Kris C P Vissers

PLOS ONE, 2017, vol. 12, issue 11, 1-21

Abstract: Neuropathic pain is clinically described as pain caused by a lesion or disease of the somatosensory nervous system. The aim of this study was to assess the validity of the Dutch version of the DN4, in a cross-sectional multicentre design, as a screening tool for detecting a neuropathic pain component in a large consecutive, not pre-stratified on basis of the target outcome, population of patients with chronic pain. Patients’ pain was classified by two independent (pain-)physicians as the gold standard. The analysis was initially performed on the outcomes of those patients (n = 228 out of 291) in whom both physicians agreed in their pain classification. Compared to the gold standard the DN4 had a sensitivity of 75% and specificity of 76%. The DN4-symptoms (seven interview items) solely resulted in a sensitivity of 70% and a specificity of 67%. For the DN4-signs (three examination items) it was respectively 75% and 75%. In conclusion, because it seems that the DN4 helps to identify a neuropathic pain component in a consecutive population of patients with chronic pain in a moderate way, a comprehensive (physical-) examination by the physician is still obligate.

Date: 2017
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0187961

DOI: 10.1371/journal.pone.0187961

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