Validation of complete Hindi version of douleur neuropathique 4 questionnaire for assessment of neuropathic pain

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.