Abstract

Objective This study aimed to validate Italian versions of Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale and Pain DETECT questionnaire (PD-Q) and evaluate the ability of these questionnaires to discriminate between nociceptive and neuropathic pain. Design Multicenter prospective validation cohort study. Subjects and Setting. One hundred patients were included with a diagnosis formulated by a specialist in outpatient settings (50 affected by knee osteoarthritis as nociceptive pain and 50 affected by trigeminal or postherpetic neuralgia as neuropathic pain). Methods The Italian versions of both questionnaires according to Italian cultural characteristics were performed according to the following steps: (1) translation of the questionnaires from English into Italian; (2) review by a bilingual individual for consistency; (3) proposed version after a mail round between experts; (4) backward translation; (5) comparison with the original English version by the experts; (6) approved version of the questionnaires. One hundred patients were enrolled and completed the two questionnaires administered by a specialist or blinded nursing staff, at the baseline and after 24/48 hours. Internal consistency, stability, validity, and discriminative power were analyzed. Results Statistically significant differences were reported about the ability of both questionnaires to discriminate between patients affected by neuropathic or nociceptive pain. Internal consistency for the Italian version of the LANSS was 0.76, and for PD-Q, it was 0.80, assessed by Cronbach's α; LANSS showed a good test-retest reliability with an ICC of 0.76, and PD-Q showed a high test-retest reliability with an ICC of 0.96. For interrater reliability, there was a concordance rate of 83.3% between reference diagnosis and LANSS (Cohen's kappa = 0.67, CI 95% 0.52–0.75). Conclusions This study validated the Italian versions of LANSS and PD-Q as reliable instruments with good psychometric characteristics, for pain evaluation, discriminating between nociceptive and neuropathic pain. Our findings were similar to those observed in the original study. Furthermore, we have reported the test-retest reliability for both questionnaires, not addressed in original validation studies.

Highlights

  • Pain treatment is a key element in the management of many chronic diseases

  • Several questionnaires have been created and validated in different languages to discriminate between different types of pain, such as the Pain DETECT questionnaire (PD-Q) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale [3, 4], which can be used in the challenging diagnosis of neuropathic pain (NeP)

  • Results e study involved 100 patients, 50 patients affected by NeP (15 men and 35 women, mean age 50 years, range 21–85 years) and 50 patients affected by nociceptive pain (20 men and 30 women, mean age 60 years, range 50–70 years)

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Summary

Introduction

Pain treatment is a key element in the management of many chronic diseases. In this regard, traditional therapeutic strategies addressed pain intensity, while, recently, a more appropriate approach taking into account the pathogenic mechanisms of pain has been widely used [1]. An Italian version of these questionnaires is not available; their translations and cross-cultural adaptations might be useful for Italian physicians to improve the management of different types of pain in clinical practice. E objectives of this study were to translate and validate Italian versions of the LANSS and PD-Q scales, as well as to investigate the ability of these tools to discriminate between inflammatory/mechanical (nociceptive) and NeP

Methods
Outcome Measures
Section B pain course pattern
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