*3.2.4 Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)*

LANSS was developed to address the less reliability of the NPS in neuropathic pain. This tool has a self-reportable version similar to BPI called S-LANASS with seven elements each weighted differently and is readily used in cancer pain assessment [20, 26, 27, 29]. Five questions mostly deal with yes or no questions for the severity, location, sensitivity, duration, etc. The last two questions are activitybased and require certain diagnostic actions such as gentle touching/rubbing the painful area [26, 29, 30]. These help in deducing if there is any nerve dysfunction, the final scoring is given by 24 [26, 29]. If the person receives a general score of less than 12 the pain is designated in the nociceptive section if the scoring is greater than 12 then the person falls in the category of neuropathic or Pain of Predominantly Neuropathic Origin (POPNO) [29, 30]. Originally designed by Michael Bennett has now been translated to many languages such as German Turkish, Chinese and even in Malayalam. It confirms the validation of this tool 101 chronic pain suffering patients were brought of which fifty patient were nociceptive and fifty-one were neuropathic the test concluded with a Cohen's Kappa 0.743(is a statistical analysis to test the reliability of a test with a range of −1 to +; generally >0.70 values are considered substantial) with 89.5% sensitivity [29, 31].

#### *3.2.5 Neuropathic Pain Questionnaire (NPQ )*

This is another method for judging and differentiating neuropathic pain from non-neuropathic pain [20]. A test regarding the validation on 528 chronic pain suffering patients of which 149 of them with neuropathic symptoms they were asked to fill up the NPQ with 12 items with the last 2 related effect of pain [32]. It was noted that it had a very low-reliability rate (66% sensitivity only) because of which it is not much popular as compared to the others [20, 30, 32]. Hence, it has been mainly used in the initial screening of neuropathic pain [20].

#### *3.2.6 Douleur Neuropathique 4 Questions (DN4)*

A ten-item scaling method utilized in the characterization of neuropathic pain has 4 questions that are simple to attempt with validated cognitive tests to prove its understandability to the patients it is administered to [21]. It has been translated into many languages and has a sensitivity of 83% [20].

#### *3.2.7 McGill Pain Questionnaire (MPQ )*

McGill pain questionnaire established by Dr. Melzack and Torgerson in 1971 at McGill University in Montreal, Canada is widely used in assessment tools for monitoring the intensity of pain [7]. Many studies have been conducted on the questionnaire such as by B Nicholson suggesting that it is a documentation method that utilizes the patient's experience like how he feels the pain, duration site, etc. [3, 7, 14]. A survey done by P. Kumar et al. showed that a total of 297 patients who underwent MPQ reported that it was qualitatively and quantitatively satisfying [7]. It gives multiple choices that help in identifying and in relating the pain suffered by the patient and these can be later compared with changes in a longer period of monitoring the patient [7, 14]. Not only that it also gives a human diagram to point out wherein the body the pain exists. With questions such as where your pain is? Is it internal or external? And the multiple-choice for how the pain changes with time, with this it seems to be quite regarded and efficient in diagnosing pain and related ailments [14].
