Validation Of The Chinese Version Of Paindetect Questionnaire And Its Application In Zoster Associated Pain

Part1Development and validation of the Chinese version painDetect questionnaire in assessing Neuropathic painObjective:The aim of this study is to investigate the validity and reliability of the Chinese version painDetect questionnaire (PD-Q) among Chinese patients.Method:Two procedures of so-called forward translation and backward translation were carried out by independent native speakers and followed by subsequent comparison and reconciliation of the translations. After evaluated by the pain specialists, the final Chinese translated version was established. Patients with either neuropathic pain (NP) or nociceptive pain (NoP) were recruited randomly from the outpatient/inpatient Neurology department of Huashan Hospital, Fudan University. The patients completed the PD-Q questionnaire by themselves and the diagnosis of NP and NoP was made by specialists. Patients were randomly selected to finish the Chinese version PD-Q again after24hours to48hours since the first visit. The optimal cutoff point of PD-Q was determined based on the statistical analysis, and were positive predictive value (PPV) and negative predictive value (NPV), sensitivity, specificity, the area under the receiver operating curve (AUC), and test-retest reliability of the translated version.Result:Among66participants,37(56.1%) of them had neuropathic pain and29(43.9%) had nociceptive pain. At an optimal PD-Q cutoff score of10, the specificity and sensitivity were93.1%and91.9%, respectively. The PPV was94.5%while the NPV was90.0%. The AUC was0.976, with95%confidence interval (CI) of0.947～1.005. Test-retest reliability in the10patients showed a good intra-class correlation of0.973.Conclusion:The Chinese version PD-Q is a relative valid and reliable scale that can be used as a diagnostic tool for neuropathic pain among Chinese patients.Part2Application of the Chinese version painDetect questionnaire in Zoster associated painObjective:The aim of this study is to explore the applicability of the Chinese version PD-Q to detect neuropathic pain in patients with zoster related pain.Method:The demographic data and history of the recruited patients were collected. All have fulfilled the Chinese version PD-Q, the hospital anxiety/depression scale (HAD) and the Pittsburgh sleep quality index (PSQI) by themselves. The results of clinical evaluation and PD-Q scoring were then compared and analyzed statistically.Result:73patients were enrolled in this study,40of them were NP and33of them were NoP diagnosed by the corresponding criteria. The AUC was0.845(95%CI:0.757～0.934). At a PD-Q cutoff point of13, the sensitivity and specificity of PD-Q questionaire were82.5%and72.7%respectively, while the PPV was78.6%and the NPV was80.2%. By using logistic regression analysis, the PD-Q score and the duration of disease was significantly related to the presence of neuropathic pain in zoster-associated pain (ZAP) patients (P<0.05)Conclusion:Chinese version PD-Q can be used in ZAP patients for discriminating the component of neuropathic pain. However, a further study with more patient population is warranted.