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 specialist's clinical assessment(1). The S-LANSS has not been validated as a telephone 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 these tools were considered candidates for neuropathic pain and invited to complete a telephone S-LANSS survey and undergo a clinical assessment by a pain specialist. 24 subjects with chronic pain but not considered candidates were controls. Agreement between the telephone S-LANSS and clinical assessment for the presence of neuropathic pain was determined.

Results 173 subjects (149 candidates, 24 controls) participated. 59 subjects had a positive S-LANSS score. Clinical assessment revealed 68 subjects had neuropathic pain; 95 subjects had nociceptive pain; 7 subjects had resolution of pain; and 3 subjects had an unclear diagnosis. 4 controls had the presence of neuropathic pain by clinical assessment. The S-LANSS compared to clinical assessment had a sensitivity of 51.5% (95%CI 39.0 – 63.8) and a specificity of 77.5% (95%CI 68.1 – 85.1).

Discussion The sensitivity of the telephone S-LANSS was less 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 sensitive as an assessment tool for neuropathic pain when used as a telephone interview or with subjects in a community setting.