Investigating the validity of the DN4 in a consecutive population of patients with chronic pain

Hans Timmerman, Monique A H Steegers, Frank J P M Huygen, Jelle J Goeman, Nick T van Dasselaar, Marcel J Schenkels, Oliver H G Wilder-Smith, André P Wolff, Kris C P Vissers

Research output: Contribution to journalArticle*Academicpeer-review


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.

Original languageEnglish
Pages (from-to)e0187961
JournalPLoS ONE
Issue number11
Publication statusPublished - 2017


  • Adult
  • Aged
  • Chronic Pain/physiopathology
  • Cross-Sectional Studies
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuralgia/physiopathology

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