ArticleEuropean journal of neurology2026
Screening Value of the I-Douleur Neuropathique 4 Questionnaire for Small Fibre Neuropathy in Patients With Painful Syndromes: Insights From 872 Skin Biopsies.
Article in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- DN4 Is Not a Screening Tool for Small Fiber Neuropathy: An Expected Result.European journal of neurology · 2026Article
- Comment on "Screening Value of the I-Douleur Neuropathique Four Questionnaire for Small Fiber Neuropathy in Patients With Painful Syndromes: Insights From 872 Skin Biopsies".European journal of neurology · 2026Article
- Screening Value of the I-Douleur Neuropathique 4 Questionnaire for Small Fibre Neuropathy in Patients With Painful Syndromes: Insights From 872 Skin Biopsies.European journal of neurology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSmall-fibre neuropathy (SFN), which is defined by the sole involvement of small sensory fibres, often leads to neuropathic pain. The diagnosis of SFN relies on clinical, neurophysiologic, and morphologic abnormalities. A decrease in intraepidermal nerve fibre density (IENFD) on a skin biopsy specimen is considered useful in the diagnosis of SFN in the appropriate clinical context. The self-administered Douleur Neuropathique 4 (I-DN4) questionnaire, designed to differentiate neuropathic from somatic pain, shows high sensitivity and specificity but has not been specifically investigated with regard to SFN.
methodsThis retrospective study examined the diagnostic accuracy of I-DN4 for SFN in 872 patients who were systematically assessed at the time of skin biopsy according to local standards of routine care, after excluding central nervous system diseases and other peripheral nerve disorders by careful clinical examination and medical history.
resultsAn I-DN4 score of ≥ 3 had a sensitivity of 93% and a specificity of 18.13% for diagnosing SFN. ROC analysis revealed an AUC of 0.53, indicating no discriminative ability for this condition. There were no correlations between the I-DN4 scores and the adjusted IENFD or proximo-distal IENFD ratio. Only the sensation of burning was a moderate predictor of SFN risk (odds ratio [OR] = 1.65; 95% confidence interval [CI], 1.04-2.68; p = 0.038). Hypoesthesia to pinprick was also associated with a moderate risk of a reduced IENFD at the distal leg (OR = 1.52; 95% CI, 1.03-2.25; p = 0.040).
conclusionsI-DN4 is not an effective standalone tool for screening SFN in patients with painful syndromes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.