The Validity and Reliability of the Turkish Version of the Toronto Clinical Scoring System

Abstract

Objective: The Toronto Clinical Scoring System has been preferred in clinical trials owing to its ease of use and its ability to classify the severity of neuropathic pain. The aim of this study to apply the Turkish version of Toronto Clinical Scoring System to Turkish patients and to determine its validity and reliability. Material and Methods: This study enrolled a total of 103 patients including 39 with diabetic polyneuropathy (diabetic polyneuropathy, group 1), 32 with diabetes mellitus but without diabetic polyneuropathy (group 2), and 32 healthy individuals (group 3). The gender, body mass index, hemoglobin A 1c and duration of diabetes were recorded respectively. The Toronto Clinical Scoring System was translated into Turkish language to determine the validity. The Leeds Assessment of Neuropathic Symptoms and Signs, Pain Detect Questionnaire, Michigan Neuropathy Screening Instrument were performed. Correlations between Toronto Clinical Scoring System and the other 3 neuropathy diagnosis scales and their relationships with the data of nerve conduction velocity were evaluated. Results: There was a strong positive correlation and a statistically significant relationship between the Toronto Clinical Scoring System and the other neuropathy diagnosis scales. When the item about "upper extremity symptoms" was removed from the first part of the Turkish version of the Toronto Clinical Scoring System, Cronbach's Alpha coefficient increased from 0.132 to 0.943. There was a significant relationship between the Toronto Clinical Scoring System and the nerve conduction velocity data. The sensitivity and specificity of Toronto Clinical Scoring System score ≥5 were 100% and 96.88%, respectively. Conclu- sion: Turkish version of the Toronto Clinical Scoring System is a reliable and valid instrument for the measurement of neuropathic pain in Turkish speaking patients with polyneuropathy.