The diagnostic accuracy and test-retest reliability of the Dutch PainDETECT and the DN4 screening tools for neuropathic pain in patients with suspected cervical or lumbar radiculopathy

Epping, R; Verhagen, AP; Hoebink, EA; Rooker, S; Scholten-Peeters, GGM

The diagnostic accuracy and test-retest reliability of the Dutch PainDETECT and the DN4 screening tools for neuropathic pain in patients with suspected cervical or lumbar radiculopathy

Epping, R Verhagen, AP

Hoebink, EA Rooker, S Scholten-Peeters, GGM

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Publication Type:: Journal Article
Citation:: Musculoskeletal Science and Practice, 2017, 30 pp. 72 - 79
Issue Date:: 2017-08-01

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Field	Value	Language
dc.contributor.author	Epping, R	en_US
dc.contributor.author	Verhagen, AP https://orcid.org/0000-0002-6195-0128	en_US
dc.contributor.author	Hoebink, EA	en_US
dc.contributor.author	Rooker, S	en_US
dc.contributor.author	Scholten-Peeters, GGM	en_US
dc.date.available	2017-05-31	en_US
dc.date.issued	2017-08-01	en_US
dc.identifier.citation	Musculoskeletal Science and Practice, 2017, 30 pp. 72 - 79	en_US
dc.identifier.issn	2468-8630	en_US
dc.identifier.uri	http://hdl.handle.net/10453/125339
dc.description.abstract	© 2017 Elsevier Ltd Background It is important to identify neuropathic pain early to guide treatment decisions and prevent chronicity. There is lack of evidence whether the Dutch painDETECT questionnaire and Douleure Neuropathique en 4 questions (DN4) can adequately assess neuropathic pain. Methods Patients suspected of cervical or lumbar radiculopathy were eligible for inclusion. The Dutch painDETECT and DN4 were considered as the index tests and were compared to the reference test consisting of the consensus expert diagnosis by using the grading system for neuropathic pain. The index tests and neuropathic pain diagnosis were blindly performed. Diagnostic accuracy was determined by calculating sensitivity, specificity, predictive values and likely hood ratios. Test-retest reliability for the index tests was assessed using Intraclass Correlation Coefficients (ICC). Results A total of 180 patients were included, of which 110 for the reliability analysis. Fifty-nine patients (33%) had neuropathic pain according to the reference test. Both the painDETECT and DN4 had moderate sensitivity of respectively 75% (95% CI: 61.6–85.0) and 76% (95% CI: 63.4–86.4) and poor specificity of respectively 51% (95% CI: 42.0–60.4) and 42% (95% CI: 33.2–51.5). Combining negative test results for both screening tools increased the sensitivity up to 83% (95% CI: 71.0–91.6). The ICC for the painDETECT was 0.91 (95% CI: 0.86–0.94) and for the DN4 0.86 (95% CI: 0.80–0.91). Conclusions The use of the Dutch painDETECT and the DN4 in patients with suspected radiculopathy should not be recommended yet. A combination of both screening tools seems most suitable to rule out neuropathic pain in patients suspected of radiculopathy. Level of evidence Diagnosis, Level 1B.	en_US
dc.relation.ispartof	Musculoskeletal Science and Practice	en_US
dc.relation.isbasedon	10.1016/j.msksp.2017.05.010	en_US
dc.subject.mesh	Lumbosacral Region	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Neuralgia	en_US
dc.subject.mesh	Radiculopathy	en_US
dc.subject.mesh	Pain Measurement	en_US
dc.subject.mesh	Sensitivity and Specificity	en_US
dc.subject.mesh	Reproducibility of Results	en_US
dc.subject.mesh	Translations	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Netherlands	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Surveys and Questionnaires	en_US
dc.title	The diagnostic accuracy and test-retest reliability of the Dutch PainDETECT and the DN4 screening tools for neuropathic pain in patients with suspected cervical or lumbar radiculopathy	en_US
dc.type	Journal Article
utslib.citation.volume	30	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1109 Neurosciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.publication-status	Published	en_US
pubs.volume	30	en_US

Abstract:

© 2017 Elsevier Ltd Background It is important to identify neuropathic pain early to guide treatment decisions and prevent chronicity. There is lack of evidence whether the Dutch painDETECT questionnaire and Douleure Neuropathique en 4 questions (DN4) can adequately assess neuropathic pain. Methods Patients suspected of cervical or lumbar radiculopathy were eligible for inclusion. The Dutch painDETECT and DN4 were considered as the index tests and were compared to the reference test consisting of the consensus expert diagnosis by using the grading system for neuropathic pain. The index tests and neuropathic pain diagnosis were blindly performed. Diagnostic accuracy was determined by calculating sensitivity, specificity, predictive values and likely hood ratios. Test-retest reliability for the index tests was assessed using Intraclass Correlation Coefficients (ICC). Results A total of 180 patients were included, of which 110 for the reliability analysis. Fifty-nine patients (33%) had neuropathic pain according to the reference test. Both the painDETECT and DN4 had moderate sensitivity of respectively 75% (95% CI: 61.6–85.0) and 76% (95% CI: 63.4–86.4) and poor specificity of respectively 51% (95% CI: 42.0–60.4) and 42% (95% CI: 33.2–51.5). Combining negative test results for both screening tools increased the sensitivity up to 83% (95% CI: 71.0–91.6). The ICC for the painDETECT was 0.91 (95% CI: 0.86–0.94) and for the DN4 0.86 (95% CI: 0.80–0.91). Conclusions The use of the Dutch painDETECT and the DN4 in patients with suspected radiculopathy should not be recommended yet. A combination of both screening tools seems most suitable to rule out neuropathic pain in patients suspected of radiculopathy. Level of evidence Diagnosis, Level 1B.

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http://hdl.handle.net/10453/125339