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Ferraro MC, McAuley JH. Clinimetrics: Douleur Neuropathique en 4 Questions (DN4). J Physiother 2024; 70:238-239. [PMID: 38531755 DOI: 10.1016/j.jphys.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 02/14/2024] [Indexed: 03/28/2024] Open
Affiliation(s)
- Michael C Ferraro
- Centre for Pain IMPACT, Neuroscience Research Australia, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - James H McAuley
- Centre for Pain IMPACT, Neuroscience Research Australia, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
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Roose E, Huysmans E, Leysen L, Mostaqim K, Van Wilgen P, Beckwée D, De Couck M, Timmermans A, Bults R, Nijs J, Lahousse A. Effect of perceived injustice-targeted pain neuroscience education compared with biomedically focused education in breast cancer survivors: a study protocol for a multicentre randomised controlled trial (BCS-PI trial). BMJ Open 2024; 14:e075779. [PMID: 38233049 PMCID: PMC10806532 DOI: 10.1136/bmjopen-2023-075779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/08/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Current treatments for pain in breast cancer survivors (BCSs) are mostly biomedically focused rather than biopsychosocially driven. However, 22% of BCSs with pain are experiencing perceived injustice, which is a known predictor for adverse pain outcomes and opioid prescription due to increased maladaptive pain behaviour. Educational interventions such as pain neuroscience education (PNE) are suggested to target perceived injustice. In addition, motivational interviewing can be an effective behavioural change technique. This trial aims to examine whether perceived injustice-targeted PNE with the integration of motivational interviewing is superior to biomedically focused pain education in reducing pain after 12 months in BCS with perceived injustice and pain. In addition, improvements in quality of life, perceived injustice and opioid use are evaluated, and a cost-effectiveness analysis will finally result in a recommendation concerning the use of perceived injustice-targeted PNE in BCSs with perceived injustice and pain. METHODS AND ANALYSIS This two-arm multicentre randomised controlled trial will recruit female BCS (n=156) with pain and perceived injustice. Participants will be randomly assigned to perceived injustice-targeted PNE or biomedically focused pain education in each centre. Both interventions include an online session, an information leaflet and three one-to-one sessions. The primary outcome (pain), secondary outcomes (quality of life, perceived injustice and outcomes for cost-effectiveness analysis) and explanatory outcomes (pain phenotyping, sleep, fatigue and cognitive-emotional factors) will be assessed at baseline and at 0, 6, 12 and 24 months postintervention using self-reported questionnaires online. Treatment effects over time will be evaluated using linear mixed model analyses. Additionally, a cost-utility analysis will be done from a healthcare payer and societal perspective. ETHICS AND DISSEMINATION The ethical agreement was obtained from the Main Ethics Committee (B.U.N.1432020000068) at the University Hospital Brussels and all other participating hospitals. Study results will be disseminated through presentations, conferences, social media, press and journals. TRIAL REGISTRATION NUMBER NCT04730154.
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Affiliation(s)
- Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- REVAL Research Group, Universiteit Hasselt, Diepenbeek, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Paul Van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Transcare Pain Transdisciplinary Pain Treatment Center, Groningen, Netherlands
| | - David Beckwée
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Marijke De Couck
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Rinske Bults
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gotenburg, Sweden
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Hardt S, Bergau SA, Jacques A, Tampin B. Short- and long-term test-retest reliability of the English version of the 7-item DN4 questionnaire - a screening tool for neuropathic pain. Scand J Pain 2023; 23:494-500. [PMID: 37354105 DOI: 10.1515/sjpain-2022-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 05/09/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES The original French version of the "Douleur Neuropathique en 4 Questions (DN4) questionnaire" is a valid screening tool for the identification of neuropathic pain (NeP). The DN4 has been translated into English, but the reliability of the English version has not yet been investigated. The aim of this study was to investigate the 7-item DN4 questionnaire in regards to short-term reliability before (T0) and immediately after (T1) the clinical examination and long-term reliability one week later (T2). METHODS A total of 222 participants (age 56.33 ± 16 years, 56 % female) were recruited from a Pain Management Department and Neurosurgery Spinal Clinic. For T2 measurements, the 7-item DN4 was sent by post with the "Patient Global Impression of Change Scale". The scale detects possible changes of symptoms, scoring from "very much improved" (1) to "very much worse" (7). Only participants whose symptoms had not changed much (scores 3-5) were included in the T0-T2 analysis. Weighted Kappa was used to analyse the reliability of the DN4 total scores and unweighted Kappa for the DN4 classifications. RESULTS Considering missing data and exclusions, data of 215 participants could be used for the T0-T1 and data of 103 participants for T0-T2 analysis. There was almost perfect agreement for the 7-item DN4 total score between T0-T1 (weighted k: 0.891, CI: 0.758-1.024) and T0-T2 (weighted k: 0.850, CI: 0.657-1.043). Classifications between neuropathic pain and no neuropathic pain showed almost perfect agreement (k: 0.835, CI: 0.755-0.915) for T0-T1 and substantial agreement (k: 0.733, CI: 0.598-0.868) for T0-T2. CONCLUSIONS The English 7-item DN4 is a reliable screening tool for neuropathic pain. ETHICAL COMMITTEE NUMBER #RGS0000001759.
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Affiliation(s)
- Svenja Hardt
- Faculty of Business Management and Social Sciences, Hochschule Osnabrück, University of Applied Sciences, Osnabrück, Lower Saxony, Germany
| | - Selina-Antonette Bergau
- Faculty of Business Management and Social Sciences, Hochschule Osnabrück, University of Applied Sciences, Osnabrück, Lower Saxony, Germany
| | - Angela Jacques
- Department of Research, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Brigitte Tampin
- Faculty of Business Management and Social Sciences, Hochschule Osnabrück, University of Applied Sciences, Osnabrück, Lower Saxony, Germany
- Department of Physiotherapy, Sir Charles Gairdner Hospital, Perth, Western Australia,Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Saxena AK, Khrolia D, Chilkoti GT, Malhotra RK. Validation of Complete Hindi Version of Douleur Neuropathique 4 Questionnaire for Assessment of Neuropathic Pain. Indian J Palliat Care 2021; 27:257-263. [PMID: 34511793 PMCID: PMC8428880 DOI: 10.25259/ijpc_340_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/17/2020] [Indexed: 12/04/2022] Open
Abstract
Objectives: The Douleur Neuropathique 4 (DN4) questionnaire is a widely used tool for the diagnosis of neuropathic pain (NP). The aim was to validate the Complete Hindi version of DN4 (CH-DN4) questionnaire. Materials and Methods: A systematic translation process was used to translate the original English DN4 into Hindi. The Hindi version was validated among patients appearing in the pain clinic of a tertiary hospital in the capital of Delhi by two different raters. We assessed the internal consistency, test–retest reliability, and inter-rater agreement, validity, sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC). Results: A total of 285 participants, out of which 153 had NP and 132 had non NP (NNP) were included in the study. The results showed our CH-DN4 to have good diagnostic accuracy, a score of ≥ 3.5 was found to be the best cut–off for the diagnosis of NP, with a sensitivity of 0.78, specificity of 0.76, a positive predictive value of 78.5%, and a negative predictive value of 74.5%. Cronbach’s α was 0.82 (95% confidence interval: 0.80–0.84), and interclass correlation coefficients was 0.95. The AUC was >0.8 indicating excellent discrimination between NP and NNP. Conclusion: The CH-DN4 questionnaire has been found to be a reliable and valid screening tool with an excellent power to discriminate between NP and NNP.
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Affiliation(s)
- Ashok K Saxena
- Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Dipanshu Khrolia
- Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Geetanjali T Chilkoti
- Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R Kumar Malhotra
- Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, India
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Role of interdigital sensory nerve conduction study as a noninvasive approach for early diagnosis of diabetic peripheral neuropathy. J Diabetes Metab Disord 2021; 20:71-75. [PMID: 34178823 DOI: 10.1007/s40200-020-00710-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
Purpose Diabetes mellitus is amongst the most common causes of polyneuropathy worldwide that can eventually terminate to irreversible complications. The remarkable impact of diabetic polyneuropathy as a debilitating condition on the healthcare system and total costs of diabetes care is undeniable. Despite the existence of numerous diagnostic tools such as routine electrophysiologic procedures, its early detection is challenging. This study designed to compare more distal techniques of electrodiagnostic testing, including interdigital sensory nerve conduction studies (NCSs), with conventional approaches and to investigate its role in confirming the early stages of polyneuropathy. Methods This cross-sectional study was performed in the Physical Medicine and Rehabilitation Department of Hazrat Fatemeh Reconstruction Surgery Hospital. Thirty one symptomatic diabetic outpatients and 23 asymptomatic nondiabetic subjects included in our study. We performed nerve conduction studies on five sensory nerves consist of the dorsal sural nerve, medial plantar nerve, digital branches of the interdigital nerves to toes I, II, and III (as a new antidromic technique). In this study, all techniques applied with a surface stimulator and pick-up electrodes. Results In the group of patients, 9 (29%) and 22 (71%) subjects had impaired and normal routine NCSs, respectively. Interestingly, the results of interdigital nerve studies were abnormal in the 17 out of 22 patients with normal routine NCSs. Also, 11 and 13 subjects had impaired medial plantar nerve and dorsal sural nerve conduction studies, respectively. Accordingly, with this new method, the prevalence of detectable diabetic neuropathy increased from 46% to 83%. Discussion We conducted this study intending to demonstrate the application of a new technique for early diagnosis of diabetic polyneuropathy, especially in the presymptomatic and subclinical neuropathies. The digital sensory branches of IDNs known as the most distal sensory nerves, which can be easily evaluated with new antidromic SNAP technique. Our method is simple, non-invasive, suitable, sensitive, and reproducible. There is no need to needle electrode or averaging technique to record an appropriate amplitude of IDN. Thus, it is recommended as a convenient electrophysiological option for early diagnosis of DPN.
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Taghizadeh G, Rodriguez-Blazquez C, Joghataei MT, Goudarzi S, Habibi SAH, Bakhsheshi M, Mehdizadeh M, Fereshtehnejad SM. Psychometric features of Neuropathic Pain Symptom Inventory in Iranian people with Parkinson's disease. Neurol Sci 2020; 42:3233-3239. [PMID: 33241536 DOI: 10.1007/s10072-020-04941-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Neuropathic pain is a type of pain reported in people with Parkinson's disease. There are various scales to evaluate the characteristics of this kind of pain. The purpose of this study was to investigate the psychometric properties of the Neuropathic Pain Symptom Inventory (NPSI), a specific scale that measures neuropathic pain in Iranian people with Parkinson's disease. METHOD Four hundred forty-seven individuals with Parkinson's disease were recruited in the study. Acceptability, internal consistency (Cronbach's alpha), and test-retest reliability (intraclass correlation coefficient, ICC) of NPSI were calculated. Dimensionality was examined through exploratory factor analysis. For convergent validity, correlations of NPSI with Douleur Neuropathic 4, Brief Pain Inventory, King's Pain Parkinson disease Scale, and Visual Analog Scale-Pain were used. Discriminative validity and sensitivity to change between On- and Off- medication states were analyzed. RESULTS A marked floor effect was observed for this scale (64.2%). Cronbach's alpha and ICC were 0.90 and 0.87, respectively. Items of NPSI were placed in 4 factors. A moderate to the strong association (rs = 0.55 to 0.85) between NPSI and other scales was obtained. The results of discriminative validity and sensitivity to change indicate the ability of NPSI to show differences between medication states. CONCLUSION The results of this study suggest that NPSI has acceptable reliability, validity, and sensitivity to change, indicating that this scale is suitable for measuring neuropathic pain in Iranian people with Parkinson's disease.
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Affiliation(s)
- Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
| | | | - Mohammad Taghi Joghataei
- Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, 1449614535, Tehran, Iran.,Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Goudarzi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tehran University of Medical Science, Tehran, Iran
| | - Sayed Amir Hasan Habibi
- Department of Neurology, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Merat Bakhsheshi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Semnan University of Medical Science, Semnan, Iran
| | - Maryam Mehdizadeh
- Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, 1449614535, Tehran, Iran. .,Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Seyed-Mohammad Fereshtehnejad
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Validity and Reliability of Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) in Iranian People with Parkinson's Disease. PARKINSONS DISEASE 2020; 2020:2793945. [PMID: 32908666 PMCID: PMC7450331 DOI: 10.1155/2020/2793945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/08/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022]
Abstract
Purpose Pain is one of the nonmotor symptoms of Parkinson's disease (PD) that, in order to be better managed, requires to be evaluated. Evaluations are done using pain assessment scales such as the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2). The goal of this study was to assess the psychometric properties of SF-MPQ-2 to measure pain in people with PD. Methods Four hundred and twenty-eight PD patients with a mean (SD) age of 60.11 (11.44) years were included. Accessibility was measured through floor and ceiling effects. Dimensionality was estimated by exploratory factor analysis. The association between SF-MPQ-2 and other scales such as Neuropathic Pain Symptom Inventory, Douleur Neuropathic 4, Brief Pain Inventory, King's Pain Parkinson's Disease Scale, and Visual Analog Scale-Pain was considered to calculate convergent validity. Internal consistency and test-retest reliability were assessed by Cronbach's alpha and intraclass correlation coefficient (ICC), respectively. Results A noticeable floor effect was found. Dimensionality results indicated four factors for this scale. A strong relationship was found between the SF-MPQ-2 total score and other scales (r = 0.55 to 0.85). In reliability analysis, Cronbach's alpha and ICC were 0.93 and 0.94 for SF-MPQ-2, respectively. Conclusion The results of this study showed that SF-MPQ-2 has adequate validity and reliability to measure pain in people with Parkinson's disease.
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Allami M, Faraji E, Mohammadzadeh F, Soroush MR. Chronic musculoskeletal pain, phantom sensation, phantom and stump pain in veterans with unilateral below-knee amputation. Scand J Pain 2019; 19:779-787. [DOI: 10.1515/sjpain-2019-0045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 05/21/2019] [Indexed: 11/15/2022]
Abstract
Abstract
Background and aims
Many individuals with lower limb loss report concerns about other musculoskeletal symptoms resulting from amputation. The objective of this study was to assess chronic musculoskeletal pain in Iranian veterans with unilateral below-knee amputation.
Methods
The participants agreed to take part in a health needs assessment and were interviewed face-to-face by trained interviewers. The assessment consisted of demographic information, wearing a prosthesis, pain locations in extremities, stump complications, severity of pains related to amputation and low back pain.
Results
Of 247 unilateral below knee amputees, 97.9% wore a prosthetic limb and times walking or standing with the prosthesis were 12.47 ± 3.84 and 4.22 ± 3.53 h a day, respectively. Low soft tissue coverage of the stump (15.4%) and symptomatic osteoarthritis in the contralateral lower extremity (40.1%) were the most common complications. The prevalence of stump pain, phantom sensations, phantom pain, low back pain, and knee pain was 84.2%, 77.3%, 73.7%, 78.1%, and 54.7% respectively. The odds ratio of stump pain in amputees with phantom pain was 2.22 times higher than those who did not experience phantom pain [OR = 2.22 (CI: 1.19–4.17); p = 0.012] and the odds ratio of low back pain was higher in amputees with stump pain [OR = 3.06 (CI: 1.50–6.21); p = 0.002].
Conclusions
This research enhances our understanding of comorbid musculoskeletal problems in below-knee amputees which can help health providers to identify rehabilitation needs and emphasizes the importance of regular assessments.
Implications
These findings underline the importance of paying closer attention to different dimensions and aspects of musculoskeletal complications in veterans with unilateral below-knee amputation.
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Affiliation(s)
- Mostafa Allami
- Janbazan Medical and Engineering Research Center (JMERC) , Tehran , IR Iran
| | - Elahe Faraji
- Department of Medical Device and Rehabilitation , Janbazan Medical and Engineering Research Center (JMERC) , No. 17, Farokh Street, Mogadase Ardabili Street , Tehran , Iran
| | - Fatemeh Mohammadzadeh
- Basic Sciences Department, Medical Faculty , Gonabad University of Medical Sciences , Gonabad , Iran
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Zhang Y, Li N, Zhao Y, Fan D. Painful Diabetic Peripheral Neuropathy Study of Chinese OutPatiEnts (PDN-SCOPE): protocol for a multicentre cross-sectional registry study of clinical characteristics and treatment in China. BMJ Open 2019; 9:e025722. [PMID: 30962233 PMCID: PMC6500332 DOI: 10.1136/bmjopen-2018-025722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Painful diabetic peripheral neuropathy (PDN) is a growing public health problem in China. Despite recent progress in treatment, there has been no nationwide study evaluating current medical practices and compliance with treatment guidelines. The primary aims of this study are to investigate the clinical characteristics and treatment practices for PDN and associated anxiety and depression in China. METHODS AND ANALYSIS Painful Diabetic Peripheral Neuropathy Study of Chinese OutPatiEnts is a cross-sectional, multicentre registry study with a target sample size of approximately 1500 people experiencing PDN. People with PDN will be treated according to current guidelines and local practices. The demographics, medical histories, Visual Analogue Scale pain scores, Patient Health Questionnaire-9 results, Generalised Anxiety Disorder-7 scores and therapies will be recorded to evaluate clinical characteristics of PDN and current treatment practices for pain, anxiety and depression. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Peking University Third Hospital Medical Science Research Ethics Committee (2018-182).The results of this study will be disseminated through peer-reviewed publications and scientific presentations. TRIAL REGISTRATION NUMBER NCT03520608.
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Affiliation(s)
- Yuanjin Zhang
- Neurology, Peking University Third Hospital, Beijing, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Yiming Zhao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Dongsheng Fan
- Neurology, Peking University Third Hospital, Beijing, China
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Salman Roghani R, Delbari A, Asadi-Lari M, Rashedi V, Lökk J. Neuropathic Pain Prevalence of Older Adults in an Urban Area of Iran: A Population-Based Study. PAIN RESEARCH AND TREATMENT 2019; 2019:9015695. [PMID: 30719350 PMCID: PMC6334371 DOI: 10.1155/2019/9015695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 11/02/2018] [Accepted: 11/22/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pain prevalence would increase as the population grows older, but the exact prevalence rate is not apparent in Iran. OBJECTIVES This study, therefore, set out to reveal the prevalence of pain, especially neuropathic type and explore its associated comorbidities among Iranian older adults in a large urban population-based survey. METHODS 5326 older people, aged ≥ 60 years, were randomly chosen by a multistage, cluster sampling method. The selected people then were interviewed by using the following instruments: a standard questionnaire about pain, questions of interview part of Douleur Neuropathique 4 Questions (DN4) and its comorbidities, GHQ-28, and a sociodemographic checklist. Descriptive statistics and multiple regression analysis were conducted to analyze the gathered data. RESULTS The average of the participants' age was 68.92 ± 7.02 years. Of 5326 participants, 2529 (47.5%) of participants were male. About one-third of this population had chronic pain. Chronic neuropathic pain prevalence was 13.7% and nociceptive in 30%. Knee pain (20.6%) and feet dysesthesia (7.8%) were the most common sites of nociceptive and neuropathic pain, respectively. Results of multiple regression analysis revealed that the major comorbidities of chronic pain were osteoporosis, disability, diabetes mellitus, and stroke. Neuropathic pain experiences were significantly associated with GHQ-28 scores (t=-11.42, P<0.001). CONCLUSIONS In addition to neuropathic pain, other subtypes of pain prevalence and the comorbidities are determined in the community-dwelling elder adults. This study highlights the importance of neuropathic pain and its adverse consequences and can be used to manage this populations' needs in Iran effectively.
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Affiliation(s)
- Reza Salman Roghani
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Delbari
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Johan Lökk
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
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Investigating the validity of the DN4 in a consecutive population of patients with chronic pain. PLoS One 2017; 12:e0187961. [PMID: 29190718 PMCID: PMC5708633 DOI: 10.1371/journal.pone.0187961] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/30/2017] [Indexed: 11/19/2022] Open
Abstract
Neuropathic pain is clinically described as pain caused by a lesion or disease of the somatosensory nervous system. The aim of this study was to assess the validity of the Dutch version of the DN4, in a cross-sectional multicentre design, as a screening tool for detecting a neuropathic pain component in a large consecutive, not pre-stratified on basis of the target outcome, population of patients with chronic pain. Patients' pain was classified by two independent (pain-)physicians as the gold standard. The analysis was initially performed on the outcomes of those patients (n = 228 out of 291) in whom both physicians agreed in their pain classification. Compared to the gold standard the DN4 had a sensitivity of 75% and specificity of 76%. The DN4-symptoms (seven interview items) solely resulted in a sensitivity of 70% and a specificity of 67%. For the DN4-signs (three examination items) it was respectively 75% and 75%. In conclusion, because it seems that the DN4 helps to identify a neuropathic pain component in a consecutive population of patients with chronic pain in a moderate way, a comprehensive (physical-) examination by the physician is still obligate.
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Gudala K, Ghai B, Bansal D. Hindi version of short form of douleur neuropathique 4 (S-DN4) questionnaire for assessment of neuropathic pain component: a cross-cultural validation study. Korean J Pain 2017; 30:197-206. [PMID: 28757920 PMCID: PMC5532527 DOI: 10.3344/kjp.2017.30.3.197] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pain with neuropathic characteristics is generally more severe and associated with a lower quality of life compared to nociceptive pain (NcP). Short form of the Douleur Neuropathique en 4 Questions (S-DN4) is one of the most used and reliable screening questionnaires and is reported to have good diagnostic properties. This study was aimed to cross-culturally validate the Hindi version of the S-DN4 in patients with various chronic pain conditions. METHODS The S-DN4 is already translated into the Hindi language by Mapi Research Trust. This study assessed the psychometric properties of the Hindi version of the S-DN4 including internal consistency and test-retest reliability after 3 days' post-baseline assessment. Diagnostic performance was also assessed. RESULTS One hundred sixty patients with chronic pain, 80 each in the neuropathic pain (NeP) present and NeP absent groups, were recruited. Patients with NeP present reported significantly higher S-DN4 scores in comparison to patients in the NeP absent group (mean (SD), 4.7 (1.7) vs. 1.8 (1.6), P < 0.01). The S-DN4 was found to have an AUC of 0.88 with adequate internal consistency (Cronbach's α = 0.80) and a test-retest reliability (ICC = 0.92) with an optimal cut-off value of 3 (Youden's index = 0.66, sensitivity and specificity of 88.7% and 77.5%). The diagnostic concordance rate between clinician diagnosis and the S-DN4 questionnaire was 83.1% (kappa = 0.66). CONCLUSIONS Overall, the Hindi version of the S-DN4 has good internal consistency and test-retest reliability along with good diagnostic accuracy.
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Affiliation(s)
- Kapil Gudala
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, SAS Nagar (Mohali), India
| | - Babita Ghai
- Department of Anesthesia and Intensive care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipika Bansal
- Clinical Research Unit, Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, SAS Nagar (Mohali), India
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