Baseline characteristics of the respondents.

Objective
This study aimed to translate the DN4 questionnaire into Nepalese version and assess its psychometric properties: diagnostic accuracy, internal consistency, and test-retest reliability.
Methods
An observational study was conducted in a tertiary level teaching hospital of Kathmandu, Nepal. We included 166 patients with chronic pain visiting a pain clinic over a period of one year. The Nepalese version of the DN4 questionnaire was used for detecting signs and symptoms of neuropathic pain. The English version of the questionnaire was translated into Nepali in accordance with the standard guideline with the help of linguistic experts. The patients who met the inclusion criteria were examined and interviewed twice in an interval of two weeks. The association between the index test and the reference test was analyzed using Chi-square test. Diagnostic accuracy was assessed using sensitivity, specificity, Youden’s index, and positive and negative predictive values. We calculated internal consistency using Cronbach’s alpha (∝), and test-retest reliability using Cohen’s kappa and Intra-class correlation coefficient (ICC).
Results
The study showed a significant association between the result of DN4 questionnaire and the gold standard (physician’s diagnosis) (p<0.001). The sensitivity and specificity values for the DN4 questionnaire were 75% and 95.3% respectively. Similarly, positive and negative predictive values were 93.8% and 80.4% respectively. Our study showed adequate internal consistency (∝ = 0.710) and a good test-retest reliability (kappa = 0.872, ICC = 0.877).
Conclusions
The Nepalese version of DN4 questionnaire is a valid and reliable tool for the identification of signs and symptoms of neuropathic pain. This can be used for screening neuropathic pain signs and symptoms in clinical as well as research settings.

研究目的
本研究旨在将DN4问卷（DN4 Questionnaire）翻译为尼泊尔语版本，并评估其心理测量学特性：诊断准确性、内部一致性与重测信度。

研究方法
本研究在尼泊尔加德满都的一所三级教学医院开展，为观察性研究。研究纳入166名在为期一年的时间内于疼痛门诊就诊的慢性疼痛患者。采用尼泊尔语版DN4问卷检测神经性疼痛的体征与症状。该问卷的英语原版经语言专家协助，按照标准指南翻译为尼泊尔语。符合纳入标准的患者于间隔两周的两个时间点接受检查与访谈。采用卡方检验分析指标测试与参照测试间的关联。通过灵敏度、特异度、尤登指数（Youden’s Index）以及阳性、阴性预测值评估诊断准确性。采用克朗巴赫α系数（Cronbach’s alpha, ∝）计算内部一致性，采用科恩κ系数（Cohen’s kappa）与组内相关系数（Intra-class Correlation Coefficient, ICC）评估重测信度。

研究结果
本研究显示，DN4问卷的检测结果与金标准（医师诊断）间存在显著关联（p<0.001）。DN4问卷的灵敏度与特异度分别为75%与95.3%。与之类似，其阳性、阴性预测值分别为93.8%与80.4%。本研究结果显示，该问卷具备良好的内部一致性（∝=0.710）与优秀的重测信度（kappa=0.872，ICC=0.877）。

结论
尼泊尔语版DN4问卷是一种用于识别神经性疼痛体征与症状的有效且可靠的工具，可应用于临床及研究场景中的神经性疼痛体征与症状筛查。