Purpose

To evaluate the 5-item dry eye questionnaire (DEQ-5) for measurement precision and unidimensionality, and assess the ability of Ocular Surface Disease Index (OSDI), McMonnies Dry Eye Questionnaire (MQ), Ocular Comfort Index questionnaires (OCI), and DEQ to predict clinical measures of DED in an African population.

Method

Participants (n = 113; mean age 24.7 ± 5.4 years) completed all four questionnaires administered in a randomized order. Internal consistency and test-retest reliability of the instruments were assessed. A masked examiner performed clinical dry eye tests in both eyes of participants and the results used to classify into either “dry” or “non-dry” groups. The diagnostic criteria for dry eye disease were tear break up time (TBUT) < 10 s plus at least one of Schirmer <15 mm in 5 min., > 5 corneal staining spot, or > 9 conjunctival staining spots. Rasch analysis was performed to assess the DEQ for unidimensionality and measurement precision, and receiver operating characteristic curve (AUC) analysis was used to assess the ability of the four questionnaires to predict clinical measures of DED.

Results

The responses from the DEQ-5 met the Rasch analysis criterion of unidimensionality with infit and outfit values of between 0.74–1.43 mean-square and 0.69–1.49 mean-square, respectively, and measurement precision of 2.33. Internal consistency and test-retest reliability of each test was high, with Cronbach alpha >0.70 for the questionnaire and their respective subscales but internal consistency reliability of the MQ was poor (Cronbach’s alpha = 0 .29−0 0.52). Each test segregated the “dry” and “non-dry” groups with moderate (all AUC 0.70−0.80) and similar accuracy (P > .05).

Conclusion

The DEQ -5 demonstrated adequate measurement precision and unidimensionality. Each of the four questionnaires showed psychometric validity for clinical use in the African population, and modest and similar accuracy when screening for dry eye signs but the performance of the McMonnies questionnaire was limited in terms of internal consistency reliability.

中文翻译：

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评估非洲队列中用于筛查干眼病的四份经过验证的问卷

目的

评估 5 项干眼问卷 (DEQ-5) 的测量精度和单维性，并评估眼表疾病指数 (OSDI)、McMonnies 干眼问卷 (MQ)、眼部舒适指数问卷 (OCI) 和DEQ 预测非洲人群中 DED 的临床测量。

方法

参与者（n = 113；平均年龄 24.7 ± 5.4 岁）以随机顺序完成了所有四份问卷。评估了仪器的内部一致性和重测信度。一名蒙面检查员对参与者的双眼进行临床干眼测试，并将结果分为“干眼”或“非干眼”组。干眼症的诊断标准是泪液破裂时间 (TBUT) < 10 s 加上 Schirmer <15 mm in 5 min.、> 5 个角膜染色点或 > 9 个结膜染色点中的至少一个。进行 Rasch 分析以评估 DEQ 的单维性和测量精度，并使用受试者工作特征曲线 (AUC) 分析来评估四份问卷预测 DED 临床测量的能力。

结果

DEQ-5 的响应符合 Rasch 单维分析标准，infit 和装备值分别在 0.74-1.43 均方和 0.69-1.49 均方之间，测量精度为 2.33。每个测试的内部一致性和重测信度都很高，问卷及其各自分量表的 Cronbach alpha >0.70，但 MQ 的内部一致性信度较差（Cronbach's alpha = 0 .29-0 0.52）。每个测试以中等（所有 AUC 0.70-0.80）和相似的准确度（P > .05）分离“干”和“非干”组。

结论

DEQ -5 表现出足够的测量精度和一维性。四份问卷中的每一份都显示了在非洲人群临床使用的心理测量有效性，在筛查干眼体征时准确性适中且相似，但 McMonnies 问卷的表现在内部一致性可靠性方面受到限制。