Introduction The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) is a self-administered assessment tool designed to identify patients with neuropathic pain and has been validated in un-aided and survey formats in subjects treated at a tertiary pain referral center with a pain secialist's clinical assessment(1). The S-LANSS has not been validated as a mailed survey in community subjects with chronic pain by clinical assessment.

Methods 5897 Olmsted County residents were surveyed via mail to assess for chronic pain, complete the S-LANSS and self-report the presence of neuropathic pain. Clinical records were reviewed to identify ICD-9 codes suggestive of neuropathic pain(2). Residents with a positive response to any of the three tools were considered candidates for neuropathic pain and invited to participate in a clinical assessment by a pain specialist. 26 subjects with chronic pain but not considered candidates underwent clinical assessment as controls. Agreement between the S-LANSS and clinical assessment for the presence of neuropathic pain was determined.

Results 205 subjects (179 candidates, 26 controls) participated. 83 subjects had a positive S-LANSS score. Clinical assessment revealed 75 subjects had neuropathic pain; 117 subjects had nociceptive pain; 10 subjects had resolution of pain; and 3 subjects had an unclear diagnosis. 6 controls had the presence of neuropathic pain by clinical assessment. The S-LANSS compared to clinical assessment had a sensitivity of 57.3% (95%CI 45.4 – 68.7) and a specificity of 69.3% (95%CI 60.5 – 77.2).

Discussion The sensitivity and sensitivity of the mailed S-LANSS was less in this study than the initial validation study, which reported a sensitivity of 74% and a specificity of 76%(1). These findings suggest that the S-LANSS is less robust as an assessment tool for neuropathic pain when used as part of a mailed survey or with subjects in a community setting.