Department of Palliative and Supportive Care, Mater Health Services, Raymond Terrace, Sth Brisbane, QLD, 4101, Australia,
Support Care Cancer. 2013 Dec;21(12):3387-91. doi: 10.1007/s00520-013-1921-5. Epub 2013 Aug 10.
The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale was developed to differentiate pain of predominantly neuropathic or nociceptive origin. The aim of this study was to determine whether the LANSS scale was an appropriate tool to classify pain in a trial of patients with advanced cancer and chronic refractory pain.
Clinician assessment of pain type (neuropathic or nociceptive) was used to determine the sensitivity and specificity of LANSS scores in 112 trial participants. Those classified as "mixed" or of uncertain aetiology were excluded. We undertook several analyses in an attempt to improve the LANSS scale and better diagnose pain type for our specific dataset.
There was strong association between the LANSS score and a diagnosis of neuropathic versus nociceptive pain, p < 0.001. When the clinical assessment was compared with the LANSS scale, the overall accuracy was 94 % (79/84). The 5 false negatives and no false positives resulted in a sensitivity of 0.86 (0.70, 0.95), specificity of 1 (0.93, 1), positive predictive value of 1 (0.88, 1) and negative predictive value of 0.91 (0.80, 0.97). The negative likelihood ratio was 0.14 (0, 0.32). The scale had good discriminant and construct validity. Reliability was assessed via internal consistency with Cronbach's α = 0.76, similar to that of the original validation study (α = 0.74). None of the new scales developed was better at differentiating pain type.
The LANSS scale predicted well for pain type in a cancer population and is a useful tool for classifying pain in cancer pain trials.
利兹评估神经性症状和体征（LANSS）量表是为了区分主要是神经性或伤害性来源的疼痛而开发的。本研究的目的是确定 LANSS 量表是否是一种合适的工具，用于分类晚期癌症和慢性难治性疼痛患者的疼痛。
临床医生对疼痛类型（神经性或伤害性）的评估用于确定 112 名试验参与者的 LANSS 评分的敏感性和特异性。将那些被归类为“混合”或病因不明的患者排除在外。我们进行了几项分析，试图改进 LANSS 量表，并为我们的特定数据集更好地诊断疼痛类型。
LANSS 评分与神经性与伤害性疼痛的诊断之间存在很强的关联，p<0.001。当将临床评估与 LANSS 量表进行比较时，整体准确性为 94%（79/84）。5 个假阴性和没有假阳性导致敏感性为 0.86（0.70，0.95），特异性为 1（0.93，1），阳性预测值为 1（0.88，1），阴性预测值为 0.91（0.80，0.97）。负似然比为 0.14（0，0.32）。该量表具有良好的判别和结构有效性。通过内部一致性评估可靠性，克朗巴赫的 α 值为 0.76，与原始验证研究相似（α=0.74）。没有一个新开发的量表在区分疼痛类型方面表现更好。
LANSS 量表在癌症人群中对疼痛类型的预测良好，是癌症疼痛试验中分类疼痛的有用工具。
