Department of Anaesthesiology, Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
Central Department of Public Health, Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
PLoS One. 2023 Jul 17;18(7):e0287737. doi: 10.1371/journal.pone.0287737. eCollection 2023.
This study aimed to translate the DN4 questionnaire into Nepalese version and assess its psychometric properties: diagnostic accuracy, internal consistency, and test-retest reliability.
An observational study was conducted in a tertiary level teaching hospital of Kathmandu, Nepal. We included 166 patients with chronic pain visiting a pain clinic over a period of one year. The Nepalese version of the DN4 questionnaire was used for detecting signs and symptoms of neuropathic pain. The English version of the questionnaire was translated into Nepali in accordance with the standard guideline with the help of linguistic experts. The patients who met the inclusion criteria were examined and interviewed twice in an interval of two weeks. The association between the index test and the reference test was analyzed using Chi-square test. Diagnostic accuracy was assessed using sensitivity, specificity, Youden's index, and positive and negative predictive values. We calculated internal consistency using Cronbach's alpha (∝), and test-retest reliability using Cohen's kappa and Intra-class correlation coefficient (ICC).
The study showed a significant association between the result of DN4 questionnaire and the gold standard (physician's diagnosis) (p<0.001). The sensitivity and specificity values for the DN4 questionnaire were 75% and 95.3% respectively. Similarly, positive and negative predictive values were 93.8% and 80.4% respectively. Our study showed adequate internal consistency (∝ = 0.710) and a good test-retest reliability (kappa = 0.872, ICC = 0.877).
The Nepalese version of DN4 questionnaire is a valid and reliable tool for the identification of signs and symptoms of neuropathic pain. This can be used for screening neuropathic pain signs and symptoms in clinical as well as research settings.
本研究旨在将 DN4 问卷翻译成尼泊尔语版本，并评估其心理测量学特性：诊断准确性、内部一致性和重测信度。
这是在尼泊尔加德满都的一所三级教学医院进行的观察性研究。我们纳入了 166 名在疼痛诊所就诊的慢性疼痛患者，时间为一年。使用 DN4 问卷的尼泊尔语版本来检测神经病理性疼痛的体征和症状。问卷的英文版本在语言专家的帮助下按照标准指南被翻译成尼泊尔语。符合纳入标准的患者在两周的间隔内接受两次检查和访谈。使用卡方检验分析指标试验与参考试验之间的关联。使用灵敏度、特异性、约登指数以及阳性和阴性预测值评估诊断准确性。我们使用 Cronbach's α（∝）评估内部一致性，使用 Cohen's kappa 和组内相关系数（ICC）评估重测信度。
研究表明 DN4 问卷的结果与金标准（医生诊断）之间存在显著关联（p<0.001）。DN4 问卷的灵敏度和特异性值分别为 75%和 95.3%。同样，阳性和阴性预测值分别为 93.8%和 80.4%。我们的研究显示出适度的内部一致性（∝=0.710）和良好的重测信度（kappa=0.872，ICC=0.877）。
DN4 问卷的尼泊尔语版本是一种用于识别神经病理性疼痛体征和症状的有效且可靠的工具。它可用于在临床和研究环境中筛查神经病理性疼痛的体征和症状。
