Validation of DN4 as a screening tool for neuropathic pain in painful diabetic polyneuropathy
Diabetic Medicine,

Spallone V et al. – This is the first validation study of DN4 for painful diabetic polyneuropathy, which supports its usefulness as both a screening tool for neuropathic pain in diabetes and a reliable component of the diagnostic work up for painful diabetic polyneuropathy.

Methods
  • In 158 patients with diabetes, the presence of diabetic polyneuropathy and neuropathic pain was assessed using scoring system for symptoms and signs, quantitative sensory testing, nerve conduction studies, pain history, numerical rating scale, and Short–Form McGill Pain Questionnaire.
  • Painful diabetic polyneuropathy was defined as the presence of diabetic polyneuropathy plus chronic neuropathic pain in the same area as neuropathic deficits.
  • A blinded investigator performed DN4.

Results
  • The DN4 score was significantly related to all the neurological and electrophysiological measurements and to Short–Form McGill Pain Questionnaire (P=0.58, P<0.0001).
  • DN4 and DN4–interview scores showed a high diagnostic accuracy for painful diabetic polyneuropathy with areas under the receiver operating characteristic curve of 0.94 and 0.93, respectively.
  • At the cut–off of 4, DN4 displayed sensitivity of 80%, specificity of 92%, positive predictive value (PPV) of 82%, negative predictive value (NPV) of 91%, and likelihood ratio for a positive result (LR+) of 9.6.
  • At the cut–off of 3, DN4–interview showed sensitivity and specificity of 84%, PPV of 71%, NPV of 92%, and LR+ of 5.3.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Internal Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Internal Medicine Articles

1 Corticosteroid treatment for community-acquired pneumonia - the STEP trial: study protocol for a randomized controlled trial Full Text Trials, July 16, 2014    Free full text    Evidence Based Medicine    Clinical Article

2 Screening pelvic examinations in asymptomatic, average-risk adult women: An evidence report for a clinical practice guideline from the American college of physicians Annals of Internal Medicine, July 2, 2014    Evidence Based Medicine    Clinical Article

3 Efficacy of varenicline combined with nicotine replacement therapy vs varenicline alone for smoking cessation: A randomized clinical trial JAMA, July 10, 2014    Evidence Based Medicine    Clinical Article

4 Buprenorphine treatment for hospitalized, opioid-dependent patients: a randomized clinical trial JAMA Internal Medicine, July 15, 2014    Evidence Based Medicine    Clinical Article

5 Statins and physical activity in older men the osteoporotic fractures in men study JAMA Internal Medicine, June 12, 2014    Evidence Based Medicine    Clinical Article

6 Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials BMJ, June 11, 2014    Evidence Based Medicine    Clinical Article

7 Challenges of infectious diseases in the USA The Lancet, July 3, 2014    Review Article    Clinical Article

8 Vitamin D and Calcium Supplementation to Prevent Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement Full Text Annals of Internal Medicine, February 26, 2013    Free full text    Clinical Guideline

9 Avoidance of sun exposure is a risk factor for all-cause mortality: results from the MISS cohort Journal of Internal Medicine, April 22, 2014    Evidence Based Medicine    Clinical Article

10 Association between melanocytic nevi and risk of breast diseases: The French E3N Prospective Cohort Full Text PLoS Medicine, July 1, 2014    Free full text    Evidence Based Medicine    Clinical Article

11 Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: A meta-analysis JAMA, June 26, 2014    Evidence Based Medicine    Clinical Article

12 Once-weekly dulaglutide versus once-daily liraglutide in metformin-treated patients with type 2 diabetes (AWARD-6): a randomised, open-label, phase 3, non-inferiority trial The Lancet, July 25, 2014    Evidence Based Medicine    Clinical Article

13 Changes in circulating leptin levels during acute stress and associations with craving in abstinent smokers: A preliminary investigation Psychoneuroendocrinology, June 20, 2014    Clinical Article

14 CPAP, weight loss, or both for obstructive sleep apnea New England Journal of Medicine, June 13, 2014    Evidence Based Medicine    Clinical Article

15 Treatment of venous thromboembolism Full Text JAMA, February 19, 2014    Free full text    Evidence Based Medicine    Clinical Article

16 Tea consumption and leukemia risk: A meta-analysis Tumor Biology, February 12, 2014    Evidence Based Medicine    Clinical Article

17 Glycated hemoglobin measurement and prediction of cardiovascular disease JAMA, March 26, 2014    Evidence Based Medicine

18 Many sudden cardiac arrests preceded by warning signs Circulation, November 20, 2013    Evidence Based Medicine    Clinical Article

19 Risk of pediatric celiac disease according to HLA haplotype and country New England Journal of Medicine, July 7, 2014    Evidence Based Medicine    Clinical Article

20 Resveratrol levels and all-cause mortality in older community-dwelling adults JAMA Internal Medicine, May 13, 2014    Evidence Based Medicine    Clinical Article

Indexed Journals in Internal Medicine: New England Journal of Medicine, The Lancet, Archives of Internal Medicinemore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close