Kim Ho Joong, Park Joon Hee, Bouhassira Didier, Shin Jae Hoon, Chang Bong Soon, Lee Choon Ki, Baek Chang Hyun, Yeom Jin S
Spine Center, Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Anesthesiology & Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Yonsei Med J. 2016 Mar;57(2):449-54. doi: 10.3349/ymj.2016.57.2.449.
To evaluate the diagnostic value of the Korean version of the Douleur Neuropathique 4 (DN4) questionnaire and to validate this questionnaire in terms of psychometric properties in patients with chronic pain due to degenerative spinal disease.
The Korean version of the DN4 questionnaire, which was translated and linguistically validated by the MAPI Research Group, was tested on 83 patients with lumbar or lumbar-radicular pain. Test-retest reliability was evaluated in a subsample of 40 patients who completed two assessments with an interval of 2 weeks. Nociceptive pain and neuropathic component pain were diagnosed in 40 and 43 patients, respectively.
The Cronbach's α coefficient of internal consistency was 0.819, and the test-retest intraclass correlation coefficient (3, 1) (95% confidence interval) was 0.813 (0.776-0.847) (n=40). The area under the receiver-operator characteristics curve was 0.953 (p<0.001), with 95% confidence interval between 0.869 and 0.990. The Korean version of the DN4 questionnaire showed a sensitivity of 100% and 87.1%, and a specificity of 88.2% and 94.1% at the cutoff value of 3/10 and 4/10, respectively, for discriminating neuropathic component pain.
The present study demonstrated the good discriminatory power of DN4 between nociceptive pain and neuropathic component pain in patients with lumbar or lumbar-radicular pain.
评估韩文版神经病理性疼痛4(DN4)问卷的诊断价值,并验证该问卷在退行性脊柱疾病所致慢性疼痛患者中的心理测量学特性。
由MAPI研究小组翻译并经语言验证的韩文版DN4问卷,在83例腰椎或腰神经根性疼痛患者中进行测试。在40例患者的子样本中评估重测信度,这些患者在间隔2周的时间内完成了两次评估。分别在40例和43例患者中诊断出伤害性疼痛和神经病理性成分疼痛。
内部一致性的Cronbach's α系数为0.819,重测组内相关系数(3,1)(95%置信区间)为0.813(0.776 - 0.847)(n = 40)。受试者操作特征曲线下面积为0.953(p < 0.001),95%置信区间在0.869至0.990之间。韩文版DN4问卷在区分神经病理性成分疼痛时,在截断值为3/10和4/10时,敏感性分别为100%和87.1%,特异性分别为88.2%和94.1%。
本研究证明了DN4在腰椎或腰神经根性疼痛患者的伤害性疼痛和神经病理性成分疼痛之间具有良好的区分能力。