Use our readymade template to create your painDETECT Questionnaire (PD-Q) for identifying neuropathic pain
Create your care assessments
| PD-Q score | Diagnosis |
|---|---|
| 0-12 | A neuropathic pain component is unlikely |
| 13-18 | Neuropathic pain can be present, but is uncertain |
| 19-38 | A neuropathic pain component is likely |
- Prebuilt template with PD-Q scoring to assess the presence of neuropathic pain and measure its severity
- Patient-completed questionnaire that scores each of the pain symptoms as “0” (never) to “5” (very strongly)
- Real-time calculation of PD-Q Score and diagnosis based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of neuropathic pain
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
| Patient ID | 1004 |
| Patient Name | John W |
| Patient Email | johnw@ymail.com |
| Patient Phone Number | 0987654321 |
| Doctor's Name | Dr. Smith |
| Location | New York |
| How would you assess your pain now, at this moment? | 5 |
| How strong was the strongest pain during the past 4 weeks? | 7 |
| How strong was the pain on average during the past 4 weeks? | 6 |
| Select the statement that best describes the course of your pain: | Persistent pain with slight fluctuations |
| Does your pain radiate to other regions of your body? | Yes |
| Do you suffer from a burning sensation (e.g., stinging nettles) in the marked areas? | Slightly |
| Do you have a tingling or prickling sensation in the area of your pain (like crawling ants or electrical tingling)? | Moderately |
| Is light touching (clothing, a blanket) in this area painful? | Strongly |
| Do you have sudden pain attacks in the area of your pain, like electric shocks? | Very Strongly |
| Is cold or heat (bath water) in this area occasionally painful? | Never |
| Do you suffer from a sensation of numbness in the areas that you marked? | Hardly Noticed |
| Does slight pressure in this area, e.g., with a finger, trigger pain? | Slightly |
| PD-Q Score | 20 |
| Diagnosis | A neuropathic pain component is likely |
- Pre-populate patient details such as patient id, name, email etc in the PD-Q assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their PD-Q assessment form prior to their visit
- Allow patients to save their progress and complete their PD-Q assessment form at a later time without losing any responses
- Set up an email template for your PD-Q assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their PD-Q score, diagnosis, next steps when they submit their PD-Q assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | Select the statement that best describes the course of your pain: | Persistent pain with slight fluctuations | 0 | 20 |
| 3 | John W | Does your pain radiate to other regions of your body? | Yes | 2 | 20 |
| 4 | John W | Do you suffer from a burning sensation (e.g., stinging nettles) in the marked areas? | Slightly | 2 | 20 |
| 5 | John W | Do you have a tingling or prickling sensation in the area of your pain (like crawling ants or electrical tingling)? | Moderately | 3 | 20 |
| 6 | John W | Is light touching (clothing, a blanket) in this area painful? | Strongly | 4 | 20 |
| 7 | John W | Do you have sudden pain attacks in the area of your pain, like electric shocks? | Very Strongly | 5 | 20 |
| 8 | John W | Is cold or heat (bath water) in this area occasionally painful? | Never | 0 | 20 |
| 9 | John W | Do you suffer from a sensation of numbness in the areas that you marked? | Hardly Noticed | 1 | 20 |
| 10 | John W | Does slight pressure in this area, e.g., with a finger, trigger pain? | Slightly | 2 | 20 |
- Export patient responses including the calculated PD-Q score and diagnosis to Google Sheets for easy record-keeping
- Export individual points for each pain symptom to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their pain symptoms
- Receive a copy of the response and the calculated PD-Q score by email whenever a patient submits their PD-Q assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
| Patient ID: | 1004 |
| Patient Name: | ****** |
| Patient Email: | ****** |
| Patient Phone Number: | ****** |
| Doctor's Name: | Dr. Smith |
| Location: | New York |
| How would you assess your pain now, at this moment?: | 5 |
| How strong was the strongest pain during the past 4 weeks?: | 7 |
| How strong was the pain on average during the past 4 weeks?: | 6 |
| Select the statement that best describes the course of your pain:: | Persistent pain with slight fluctuations |
| Does your pain radiate to other regions of your body?: | Yes |
| Do you suffer from a burning sensation (e.g., stinging nettles) in the marked areas?: | Slightly |
| Do you have a tingling or prickling sensation in the area of your pain (like crawling ants or electrical tingling)?: | Moderately |
| Is light touching (clothing, a blanket) in this area painful?: | Strongly |
| Do you have sudden pain attacks in the area of your pain, like electric shocks?: | Very Strongly |
| Is cold or heat (bath water) in this area occasionally painful?: | Never |
| Do you suffer from a sensation of numbness in the areas that you marked? : | Hardly Noticed |
| Does slight pressure in this area, e.g., with a finger, trigger pain?: | Slightly |
| PD-Q Score: | 20 |
| Diagnosis: | A neuropathic pain component is likely |
| PD-Q Score: | 20 |
| Diagnosis: | A neuropathic pain component is likely |
- Create a HIPAA compliant PD-Q assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting PD-Q form responses to Google Sheets and sending them on email
- Prepopulate patient details in PD-Q assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
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