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ObjectiveThis study aimed to translate and validate DN4 questionnaire into Nepalese version.DesignAn observational study design was adopted.SettingA tertiary level teaching hospital of Kathmandu, NepalParticipantsWe included 166 purposively selected patients visiting pain clinics of the hospital over one year timeMethodsThe Nepalese version of the DN4 questionnaire was used to detect neuropathic pain among the chronic pain patients of the hospital. The English version of the questionnaire was translated into Nepali based on the standard guideline with the help of linguistic experts. The patients diagnosed with nociceptive or neuropathic pain were interviewed twice in two weeks interval. We analyzed test-retest reliability and strength of the test by using Intra-class correlation coefficient (ICC) and Receiver Operating Characteristics (ROC) Curve, respectively. Internal Consistency reliability was assessed using Cronbach’s alpha (∞). Diagnostic accuracy was assessed through measures like sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratio.ResultsThe study showed a good test-retest reliability (ICC=0.877) and internal consistency reliability (∞=0.710). The AUC were 0.932 (0.894-0.971) for the first test, and 0.955 (0.921-0.990) for the second test. The sensitivity and specificity values were found highest at the 4 cut-off point (4 score out of 10), that are 75% and 95.3% for test 1, and 76.2% and 98.8% for test 2. Similarly positive and negative predictive values are 93.8% and 80.4% respectively for the first test and 98.4% and 81.7% respectively for the second test.ConclusionsThe Nepalese version of DN4 questionnaire is a valid and reliable tool for the diagnosis of neuropathic pain. This can be used for screening neuropathic and non-neuropathic pain in clinical as well as epidemiological settings.Article SummaryStrengths and Limitations of this StudyThis study validated Nepalese version of DN4 questionnaire, so, it can be used as a standard tool to assess neuropathic pain among the Nepalese population.As interview was conducted with the patients, this might minimize the reliability and validity issue.This questionnaire is only applicable to those who can communicate properly in Nepalese language.There can be problem of understanding among the participants as few words do not have exact Nepali words with the same meaning. |
