Table 1. Comparison of NP assessment... | American Society of Hematology

Table 1.

Comparison of NP assessment tools

Modality	Tool	Description	Utility	Limitations
Patient-reported outcome (PRO) (gold standard)	Douleur neuropathique 4 questions	10 items Incorporates physical examination findings* Sensitivity 83% Specificity 90%	• Validated for NP as a self-report tool	Not validated in SCD Validated for NP secondary to injury or discrete insult
	Identification Pain questionnaire	6 items Sensory descriptors only	Validated for NP More useful as a screening tool	Not validated in SCD Limited descriptors interrogated
	Leeds Assessment of Neuropathic Symptoms and Signs	7 items Incorporates physical examination findings* Sensitivity 82%-91% Specificity 80%-94%	Validated for NP as a self-report tool Studied in SCD Demonstrated sensitivity to treatment effect	• Not formally validated in SCD
	Neuropathic Pain Questionnaire	12 items Incorporates affect-type symptoms Sensitivity 66% Specificity 74%	Validated for NP Short form with only 3 items performed similarly	Not validated in SCD Questionable accuracy
	PainDETECT	9 items Incorporates temporal and spatial pain characteristics Sensitivity 85% Specificity 80%	Validated for NP as a self-report tool Scaled answers add nuance vs yes/no answers Studied in SCD	Developed for back pain Not formally validated in SCD
	PAINReportIt	>90 items Assesses pain quality, intensity, location, pattern, treatment response	Validated for NP as a computerized self-report tool Formally validated in SCD³⁵ Less bias (patient selects descriptors) Some answers scaled rather than yes/no	More time intensive (15-20 min) Language may be difficult for less well-educated patients Cost (commercially available)
	PROMIS	More comprehensive than others Customizable for assessment goal Assesses many domains, including sensory, affect, quality of life	Includes NP domain Comprehensive assessment of pain experience	Minimal data thus far for SCD and NP More time intensive
QST	Manual von Frey filaments for mechanical QST, various digital instruments available for mechanical and thermal QST	• Assesses patient response to different stimuli to determine detection and pain thresholds	Potential for future treatment monitoring Differentiation of central from peripheral sensitization Operator training relatively simple	Expensive instrument cost (subsequently low cost to operate) Time intensive No defined diagnostic cutoffs Used only on a research basis
Imaging	MRI fMRI PET EEG	• Established chronic pain patterns for each (on a research basis)	• Potential as a more objective measure than others	Expensive with every test Subspecialist training required for interpretation/analyses Patterns identified for chronic pain but not NP Needs further study Not widely available

Modality	Tool	Description	Utility	Limitations
Patient-reported outcome (PRO) (gold standard)	Douleur neuropathique 4 questions	10 items Incorporates physical examination findings* Sensitivity 83% Specificity 90%	• Validated for NP as a self-report tool	Not validated in SCD Validated for NP secondary to injury or discrete insult
	Identification Pain questionnaire	6 items Sensory descriptors only	Validated for NP More useful as a screening tool	Not validated in SCD Limited descriptors interrogated
	Leeds Assessment of Neuropathic Symptoms and Signs	7 items Incorporates physical examination findings* Sensitivity 82%-91% Specificity 80%-94%	Validated for NP as a self-report tool Studied in SCD Demonstrated sensitivity to treatment effect	• Not formally validated in SCD
	Neuropathic Pain Questionnaire	12 items Incorporates affect-type symptoms Sensitivity 66% Specificity 74%	Validated for NP Short form with only 3 items performed similarly	Not validated in SCD Questionable accuracy
	PainDETECT	9 items Incorporates temporal and spatial pain characteristics Sensitivity 85% Specificity 80%	Validated for NP as a self-report tool Scaled answers add nuance vs yes/no answers Studied in SCD	Developed for back pain Not formally validated in SCD
	PAINReportIt	>90 items Assesses pain quality, intensity, location, pattern, treatment response	Validated for NP as a computerized self-report tool Formally validated in SCD³⁵ Less bias (patient selects descriptors) Some answers scaled rather than yes/no	More time intensive (15-20 min) Language may be difficult for less well-educated patients Cost (commercially available)
	PROMIS	More comprehensive than others Customizable for assessment goal Assesses many domains, including sensory, affect, quality of life	Includes NP domain Comprehensive assessment of pain experience	Minimal data thus far for SCD and NP More time intensive
QST	Manual von Frey filaments for mechanical QST, various digital instruments available for mechanical and thermal QST	• Assesses patient response to different stimuli to determine detection and pain thresholds	Potential for future treatment monitoring Differentiation of central from peripheral sensitization Operator training relatively simple	Expensive instrument cost (subsequently low cost to operate) Time intensive No defined diagnostic cutoffs Used only on a research basis
Imaging	MRI fMRI PET EEG	• Established chronic pain patterns for each (on a research basis)	• Potential as a more objective measure than others	Expensive with every test Subspecialist training required for interpretation/analyses Patterns identified for chronic pain but not NP Needs further study Not widely available

Tools used in published studies of SCD are in bold. Sensitivity/specificity numbers are reported on the basis of performance relative to expert clinical diagnosis. None have been formally validated against expert clinical examination in the SCD population.

Tools incorporating physical examination findings have higher reported sensitivity and specificity than interview-only tools.³⁶

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