Table 1. Validated Pain Rating Scales Brief Pain Inventory for Diabetic Peripheral Neuropathy
` Assesses severity of pain, effect of pain on daily functioning, location of pain (body map), relief from medication
` 4-Item pain severity questionnaire (worst pain [most predictive of mild, moderate, severe pain], least pain, average pain, pain now)
` 7-Item pain interference with daily life assessment (general activity, mood, walking ability, normal work, relations with others, sleep, enjoyment of life)
` Each item uses 11-point scale (0 = no pain to 10 = worst pain imaginable or complete interference); asks patient specifically about pain related to diabetes during past 24 hours
> 0–3 suggest mild pain/interference > 4–6 suggest moderate pain/interference > 7 + suggest severe pain/interference
` 58% Sensitivity (using worst pain); 79% specificity Leeds Assessment of Neuropathic Symptoms and Signs ` Differentiates between neuropathic and non-neuropathic pain ` 7-Item questionnaire: maximum score 24; score ≥ 12 suggests neuropathic pain ` 83% Sensitivity; 87% specificity Michigan Neuropathy Screening Instrument ` Outpatient primary care screening for DPN
` 15-Item self-administered patient history questionnaire about feeling in legs and feet; detailed 4-item healthcare professional physical assessment (foot inspection, vibration sensation, muscle stretch reflexes, monofilament testing)
Neuropathic Pain Questionnaire ` Differentiates between neuropathic and non-neuropathic pain ` May be used to assess effect of treatment ` 12-Item questionnaire assesses pain qualities distinct to neuropathic pain ` 67% Sensitivity; 74% specificity Neuropathic Pain Scale ` Assesses pain qualities distinct to neuropathic pain ` Differentiates levels of responsivity to pain treatment ` 10-Item questionnaire: > 2 Global pain domains (intensity, unpleasantness) > 6 Pain qualities (sharp, dull, hot, cold, sensitive, itchy) ` 83% Sensitivity; 87% specificity
