Neuropathic pain screening questionnaires have limited measurement properties. A systematic review

Stephanie Mathieson; Christopher G Maher; Caroline B Terwee; Tarcisio Folly de Campos; Chung-Wei Christine Lin

doi:10.1016/j.jclinepi.2015.03.010

Neuropathic pain screening questionnaires have limited measurement properties. A systematic review

J Clin Epidemiol. 2015 Aug;68(8):957-66. doi: 10.1016/j.jclinepi.2015.03.010. Epub 2015 Mar 23.

Authors

Stephanie Mathieson¹, Christopher G Maher², Caroline B Terwee³, Tarcisio Folly de Campos², Chung-Wei Christine Lin²

Affiliations

¹ Musculoskeletal Department, The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 13, 321 Kent St, Sydney, NSW 2000, Australia. Electronic address: smathieson@georgeinstitute.org.au.
² Musculoskeletal Department, The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 13, 321 Kent St, Sydney, NSW 2000, Australia.
³ Department of Epidemiology and Biostatistics, The EMGO(+) Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7 1081 BT, Amsterdam, The Netherlands.

PMID: 25895961
DOI: 10.1016/j.jclinepi.2015.03.010

Abstract

Objectives: The Douleur Neuropathique 4 (DN4), ID Pain, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), PainDETECT, and Neuropathic Pain Questionnaire have been recommended as screening questionnaires for neuropathic pain. This systematic review aimed to evaluate the measurement properties (eg, criterion validity and reliability) of these questionnaires.

Study design and setting: Online database searches were conducted and two independent reviewers screened studies and extracted data. Methodological quality of included studies and the measurement properties were assessed against established criteria. A modified Grading of Recommendations Assessment, Development and Evaluation approach was used to summarize the level of evidence.

Results: Thirty-seven studies were included. Most studies recruited participants from pain clinics. The original version of the DN4 (French) and Neuropathic Pain Questionnaire (English) had the most number of satisfactory measurement properties. The ID Pain (English) demonstrated satisfactory hypothesis testing and reliability, but all other properties tested were unsatisfactory. The LANSS (English) was unsatisfactory for all properties, except specificity. The PainDETECT (English) demonstrated satisfactory hypothesis testing and criterion validity. In general, the cross-cultural adaptations had less evidence than the original versions.

Conclusion: Overall, the DN4 and Neuropathic Pain Questionnaire were most suitable for clinical use. These screening questionnaires should not replace a thorough clinical assessment.

Keywords: DN4; ID pain; LANSS; Neuropathic pain; PainDETECT; Questionnaire.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Humans
Mass Screening*
Neuralgia / diagnosis*
Pain Measurement / methods*
Surveys and Questionnaires*