Department of Optometry and Vision Science, University of Cape Coast, Ghana.
Department of Optometry and Vision Science, University of Cape Coast, Ghana.
Cont Lens Anterior Eye. 2022 Apr;45(2):101468. doi: 10.1016/j.clae.2021.101468. Epub 2021 May 17.
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.
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.
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).
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.
评估 5 项干眼问卷（DEQ-5）的测量精度和维度，并评估眼表面疾病指数（OSDI）、McMonnies 干眼问卷（MQ）、眼舒适度指数问卷（OCI）和 DEQ 预测非洲人群干眼临床指标的能力。
参与者（n=113；平均年龄 24.7±5.4 岁）以随机顺序完成所有四项问卷。评估了仪器的内部一致性和重测信度。一位蒙住眼睛的检查者对参与者双眼进行了临床干眼测试，并根据测试结果将其分为“干眼”或“非干眼”组。干眼疾病的诊断标准为泪膜破裂时间（TBUT）<10s 加上至少一项 Schirmer <15mm 在 5 分钟内，>5 个角膜染色斑点，或>9 个结膜染色斑点。进行了 Rasch 分析，以评估 DEQ 的维度和测量精度，并使用接收者操作特征曲线（AUC）分析评估四个问卷预测干眼临床指标的能力。
DEQ-5 的反应符合维度的 Rasch 分析标准，平均平方 infit 和 outfit 值分别为 0.74-1.43 和 0.69-1.49，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，问卷及其各自的分量表的 Cronbach alpha>0.70，但 MQ 的内部一致性可靠性较差（Cronbach's alpha=0.29-0.52）。每个测试都以中等（所有 AUC 0.70-0.80）和相似的准确性（P>0.05）将“干眼”和“非干眼”组分开。
DEQ-5 表现出足够的测量精度和维度。在非洲人群中，这四个问卷都具有临床使用的心理测量有效性，并且在筛查干眼迹象时具有适度和相似的准确性，但 McMonnies 问卷的性能在内部一致性可靠性方面受到限制。
