Terkawi Abdullah Sulieman, Abolkhair Abdullah, Didier Bouhassira, Alzhahrani Tariq, Alsohaibani Mazen, Terkawi Yazzed Sulieman, Almoqbali Yousuf, Tolba Yasser Younis, Pangililan Evelyn, Foula Farida, Tsang Siny
Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA.
Department of Anesthesiology, King Fahd Medical City, Riyadh, Saudi Arabia.
Saudi J Anaesth. 2017 May;11(Suppl 1):S31-S39. doi: 10.4103/sja.SJA_97_17.
The douleur neuropathique 4 (DN4) questionnaire is a widely used tool for diagnosis of neuropathic pain (NP). The aim was to translate, culturally adapt, and validate the DN4 questionnaire in Arabic.
A systematic translation process was used to translate the original English DN4 into Arabic. After the pilot study, the Arabic version was validated among patients with chronic pain in two tertiary care centers. The reliability of the translated version was examined using internal consistency, test-retest reliability, and intraclass correlation coefficients. We examined the validity of the Arabic DN4 via construct validity, concurrent validity (associations with the numeric rating scale, brief pain inventory, and Self-Completed Leeds Assessment of Neuropathic Symptoms and Signs [S-LANSS]), face validity, and diagnostic validity. To investigate the responsiveness, the translated DN4 was administered twice among the same group of patients.
A total of 142 subjects (68 men, 74 women) were included in the study. Cronbach's α was 0.67 (95% confidence interval [CI]: 0.59-0.75), and interclass correlation coefficients was 0.81 (95% CI: 0.76-0.87). The DN4 was moderately associated with the S-LANSS questionnaire. Results showed our Arabic DN4 to have good diagnostic accuracy, with area under the curve of 0.88 (95% CI: 0.82-0.94). As with the original version, a score of ≥4 was found to be the best cut-off for the diagnosis of NP, with a sensitivity of 88.31%, specificity of 74.47%, a positive predictive value of 85%, and a negative predictive value of 80%. Most patients found the DN4 questionnaire to be clear and easy to understand, and thought the questionnaire items covered all their problem areas regarding their pain.
Our Arabic version of the DN4 is a reliable and valid screening tool that can be easily administered among patients to differentiate between NP and non-NP.
神经病理性疼痛4（DN4）问卷是一种广泛用于诊断神经病理性疼痛（NP）的工具。目的是将DN4问卷翻译成阿拉伯语，进行文化调适并验证其有效性。
采用系统翻译流程将原始英文DN4问卷翻译成阿拉伯语。在预试验之后，在两个三级护理中心的慢性疼痛患者中对阿拉伯语版本进行验证。使用内部一致性、重测信度和组内相关系数来检验翻译版本的信度。我们通过结构效度、同时效度（与数字评定量表、简明疼痛问卷以及神经病理性症状和体征自我完成利兹评估[S-LANSS]的相关性）、表面效度和诊断效度来检验阿拉伯语DN4问卷的效度。为了研究反应度，在同一组患者中对翻译后的DN4问卷进行了两次发放。
共有142名受试者（68名男性，74名女性）纳入研究。克朗巴哈α系数为0.67（95%置信区间[CI]：0.59 - 0.75），组内相关系数为0.81（95% CI：0.76 - 0.87）。DN4问卷与S-LANSS问卷呈中度相关。结果显示我们的阿拉伯语DN4问卷具有良好的诊断准确性，曲线下面积为0.88（95% CI：0.82 - 0.94）。与原始版本一样，发现≥4分是诊断NP的最佳截断值，灵敏度为88.31%，特异度为74.47%，阳性预测值为85%，阴性预测值为80%。大多数患者认为DN4问卷清晰易懂，并认为问卷项目涵盖了他们疼痛方面的所有问题领域。
我们的阿拉伯语版DN4问卷是一种可靠且有效的筛查工具，可轻松应用于患者，以区分NP和非NP。
