Weingarten Toby N, Watson James C, Hooten W Michael, Wollan Peter C, Melton L Joseph, Locketz Adam J, Wong Gilbert Y, Yawn Barbara P
Division of Pain Medicine, Department of Anesthesia, Mayo Clinic College of Medicine, Rochester, MN, USA.
Pain. 2007 Nov;132(1-2):189-94. doi: 10.1016/j.pain.2007.07.030. Epub 2007 Sep 14.
The Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), an assessment tool to determine if pain is predominantly neuropathic, has not been validated in a community setting. Previously identified residents of Olmsted County, Minnesota, with chronic pain were recruited using a stratified randomization process to increase the frequency of neuropathic pain in the study sample. Subjects completed the S-LANSS in mailed and telephone formats, and underwent clinical assessment to determine if a component of their pain was neuropathic. Sensitivity and specificity of the S-LANSS as compared to the clinical assessment were determined. Two hundred and five subjects participated in the study. Eighty-three subjects (40%) had a positive S-LANSS score in the mailed, as did 59 of 173 (34%) in the telephone format, with little inter-subject difference in scores (p=0.57). Clinical assessment identified a component of neuropathic pain in 37% of the sample (75/205). Compared to clinical assessment, sensitivity and specificity in the mailed S-LANSS were 57% (95% CI, 46-69%) and 69% (95% CI, 61-77%), respectively, and in the telephone S-LANSS were 52% (95% CI, 39-64%) and 78% (95% CI, 68-85%), respectively. The sensitivity and specificity of the S-LANSS in both formats were lower than the initial S-LANSS validation study. Differences in survey format and subject population could account for these differences, suggesting that the S-LANSS is best suited as a screening tool and its use to determine the prevalence of neuropathic pain in population studies should be viewed cautiously.
自我管理的利兹神经病理性症状和体征评估量表（S-LANSS）是一种用于确定疼痛是否主要为神经病理性的评估工具，尚未在社区环境中得到验证。先前在明尼苏达州奥尔姆斯特德县确定的患有慢性疼痛的居民通过分层随机化过程招募，以增加研究样本中神经病理性疼痛的发生率。受试者通过邮寄和电话形式完成S-LANSS，并接受临床评估以确定其疼痛的一部分是否为神经病理性。确定了S-LANSS与临床评估相比的敏感性和特异性。205名受试者参与了该研究。83名受试者（40%）邮寄形式的S-LANSS评分为阳性，173名受试者中有59名（34%）电话形式的评分为阳性，受试者之间的评分差异很小（p=0.57）。临床评估确定样本中有37%（75/205）存在神经病理性疼痛成分。与临床评估相比，邮寄形式的S-LANSS的敏感性和特异性分别为57%（95%CI，46-69%）和69%（95%CI，61-77%），电话形式的S-LANSS的敏感性和特异性分别为52%（95%CI，39-64%）和78%（95%CI，68-85%）。两种形式的S-LANSS的敏感性和特异性均低于最初的S-LANSS验证研究。调查形式和受试者群体的差异可能解释了这些差异，这表明S-LANSS最适合作为一种筛查工具，在人群研究中使用它来确定神经病理性疼痛的患病率时应谨慎看待。
