Objective Although the presence of neuropathic pain (NP) components has been reported in whiplash-associated disorders (WAD), no studies have analyzed the usefulness of NP screening questionnaires to detect NP components in WAD. This study aimed to assess the usefulness of three screening NP tools (Douleur Neuropathique 4 [DN4], self-administered Leeds Assessment of Neuropathic Symptoms and Signs [S-LANSS], and painDETECT questionnaire [PDQ]) to detect the presence of NP components in acute WAD. Design A cross-sectional study. Setting Hospital. Subjects Of 188 eligible individuals, fifty people (68% women, mean age = 40.3 ± 12.5 years) with acute WAD (52% Grade III) were included. Methods Specialized physicians initially screened participants for the presence of NP components according to clinical practice and international recommendations. After physician assessment, blinded investigators assessed participants using NP screening questionnaires (DN4, S-LANSS, PDQ) within 2 weeks of accident. Diagnostic accuracy of these tools was analyzed and compared to the reference standard (physicians’ assessments). Results : The three screening questionnaires showed excellent discriminant validity (area under the curve [AUC] ≥ 0.8), especially S-LANSS (AUC : 0.9; p < 0.001). DN4 demonstrated the highest sensitivity (87%) followed by S-LANSS (75%), while S-LANSS and PDQ showed the highest specificity (85% and 82%, respectively). These tools demonstrated a strong correlation with the reference standard (S-LANSS: Rho = 0.7; PDQ: Rho = 0.62; DN4: Rho = 0.7; all, p < 0.001). Conclusions The DN4, S-LANSS and PDQ show excellent discriminant validity to detect the presence of NP components in acute WAD, especially S-LANSS. Initial screening with these tools might improve management of WAD.

中文翻译：

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DN4、S-LANSS 和 painDETECT 筛查问卷在检测急性颈部扭伤相关疾病患者的神经病理性疼痛成分方面的有用性：一项横断面研究

目的 尽管颈椎扭伤相关疾病 (WAD) 中存在神经性疼痛 (NP) 成分，但尚无研究分析 NP 筛查问卷在检测 WAD 中 NP 成分的有效性。本研究旨在评估三种 NP 筛查工具（Douleur Neuropathique 4 [DN4]、自我管理的 Leeds 神经病理症状和体征评估 [S-LANSS] 和 painDETECT 问卷 [PDQ]）检测 NP 成分是否存在的有用性急性WAD。设计横断面研究。设置医院。受试者 在 188 名符合条件的个体中，包括 50 名患有急性 WAD 的人（68% 为女性，平均年龄 = 40.3 ± 12.5 岁）（52% 为 III 级）。方法 专业医师根据临床实践和国际建议初步筛查参与者是否存在 NP 成分。经过医生评估后，盲法研究人员在事故发生后 2 周内使用 NP 筛查问卷（DN4、S-LANSS、PDQ）对参与者进行评估。对这些工具的诊断准确性进行了分析，并与参考标准（医生的评估）进行比较。结果：三份筛查问卷显示出优异的区分效度（曲线下面积 [AUC] ≥ 0.8），尤其是 S-LANSS（AUC：0.9；p < 0.001）。DN4 表现出最高的敏感性 (87%)，其次是 S-LANSS (75%)，而 S-LANSS 和 PDQ 表现出最高的特异性（分别为 85% 和 82%）。这些工具显示出与参考标准的强相关性（S-LANSS：Rho = 0.7；PDQ：Rho = 0.62；DN4：Rho = 0.7；全部，p < 0.001）。结论 DN4、S-LANSS 和 PDQ 在检测急性 WAD 中 NP 成分的存在，特别是 S-LANSS 方面表现出良好的判别效度。使用这些工具进行初步筛查可能会改善 WAD 的管理。