Formulating And Evaluating Of Chinese Version Of DN4 Neuropathic Component Questionnaire

Objective:To develop and verify Chinese version DN4 scale,to provide a new diagnosis scale for chronic neuropathic pain.Methods:1.Developing Chinese DN4 scale: in order to ensure the linguistics reliability and authenticity of the DN4 translation, the international translation methods was adopted,useing four steps: forword-translation, back-translation, expert discussions, preliminary experiment in the crowd then formulating the final Chinese version.2.Verify the scale: Inpatients with chronic pain which came from the department of neurologypain,orthopaedic, rheumatology and endocrinologist in Firist affilaited hospital of Shanxi medical university from January 2014 to September was continuously enrolled in this study. the graduate students completed the questionnaire and the demographic information collection of patients prior to treatment who conform to the inclusion criteria,adopting the way of face to face to complete the questionnaire. Ensure that the graduate student was blind to whether patients are chronic neurological pain or not when completing the questionnaire.Visual analog pain Scale(VAS) were evaluated was used to evluated the pain level.3.Assessment scale: the scale reliability was evaluated through he internal consistency coefficient which is Cronbach’s alpha coefficient, each entry score with dimension scores of sperman ’s r correlation coefficient was calculated to evaluated questionnaire validity.Through indcators such as sensitivity, specific, Youden index, likelihood ratio, positive predictive value, negative predictive value,receiver operating characteristic curve toevaluat diagnostic value of the test. According to the level of education, the degree of pain,pain time the date was stratified,the diagnostic value of Chinese version DN4 scale in different crowd was analysed.Results:1.The study took a total of 156 a questionnaire survey, excluding incomplete questionnaire in baseline data and not meeting the inclusion criteria in pain durationeventually,so finally 123 patients was included, among which 73 were neuropathic pain patients,50 cases were neuropathic pain. Neuropathy pain before the frist three main pathogeny of neuropathic pain were lumbar nerve root lesion(27.4%),post-herpetic neuralgia(19.2%), trigeminal neuralgia(11.0%).2.the questionnaire’s overall Cronbach’s a coefficien was 0.713, the first three dimensions of Cronbach’s a coefficient was 0.741、0.736、0.904 respectively. the smallest item of Sperman ’s r correlation was the item "painful cold", the corresponding r value was0.516, the highest r value was "Hypoerthesia to touch”, r value was 0.930.3.This scale’s best cut-off point was the 4/10 points, the sensitivity was 60.3%, the specifcity was 94.0%, positive predictive value was 93.6, negative predictive value was61.8, the area under the curve is 0.823, 95% CI was 0.747-0.899.4.According to the level of education, the degree of pain, pain time,data was stratified analysed.In the study of education level sub-group, university or above level the group has the minimum coincidence rate,and the highest group was the primary school and the following group; In hierarchical analysis of pain degree, the mild pain sub-group has the lowest indicators such as sensitivity, specific degrees, Youden index; and each index is the best in medium pain sub-group; In pain long analysis, the indicators are relatively poor in pain duration for 24 months or more sub-group. But after chi-square test for coincidence rate difference in each sub-group had no statistical significance.Conclusions:1.Trough forword-translation,back-translation,expert discussions, preliminary experiment in the crowd four steps, the final Chinese version DN4 scale was formulated.,After evaluation of reliability and validity, diagnostic test, Chinese DN4 scale can be used as a diagnostic tool for identifying neuropathy pain.2.In the scale reliability index the total scale and each dimension of Cronbach’s αcoefficient and validity index entries correlation were all performed well.3.under the best cut-off value the scale’s indicators such as sensitivity, specific degrees, Youden index, the likelihood ratio, the positive predictive value, negative predictive value, and area under the curve were performing well, but sensitivity relatively was low, specific degree was high. this was likely to connected with the object of study in etiology and degree of pain, it remains need to be further confirmed.4.DN4 scale is easy to understand, adaptes to the various cultural groups, just need to understand local language; In different degree of pain such an mild pain, moderate pain,severe pain,DN4 scale has the same diagnostic value, but in mild pain group the diagnostic value of the DN4 has the trend of decreas, but has no statistical difference.