Psychometric Properties and Validation of the Standard Patient Evaluation of Eye Dryness Questionnaire

PURPOSE To characterize the psychometric properties of the standard patient evaluation of eye dryness (SPEED) questionnaire and to validate and compare its performance with 4 existing dry eye questionnaires. METHODS A total of 50 subjects (40 female and 10 male) were enrolled; of these, 30 were symptomatic and 20 asymptomatic, as determined using the ocular surface disease index (OSDI). This study consisted of 2 visits in which all subjects completed 5 different dry eye questionnaires (SPEED, OSDI, dry eye questionnaire, McMonnies dry eye questionnaire, and subjective evaluation of symptom of dryness) in random order at each visit. Clinical measurements were obtained on the first visit. Repeatability was determined using concordance correlation coefficient; dimensionality was determined using principal component, factor, and Rasch analyses; and validity was determined by comparing SPEED scores with dry eye diagnosis based on OSDI (primarily using receiver-operator curve analysis). RESULTS The SPEED questionnaire data were found to be unidimensional and repeatable. Three principal components (dryness, burning, and soreness/fatigue) were identified and SPEED between visit concordance correlation coefficient was 0.923 (95% confidence interval, 0.868-0.955). The area under the receiver-operator curves was 0.928. The only clinical measures that correlated "well" with SPEED questionnaire scores were corneal staining (P < 0.05), meibomian gland score (P < 0.05), and meibomian glands yielding liquid secretion score (P < 0.05). CONCLUSIONS The SPEED questionnaire was shown to be a repeatable and valid instrument for measurement of dry eye symptoms. The SPEED score also correlated significantly with ocular surface staining and clinical measures of meibomian gland function.

[1]  J. Pepose,et al.  Clinical Utility of Objective Tests for Dry Eye Disease: Variability Over Time and Implications for Clinical Trials and Disease Management , 2012, Cornea.

[2]  K. Tsubota,et al.  The international workshop on meibomian gland dysfunction: executive summary. , 2011, Investigative ophthalmology & visual science.

[3]  R. Bedi,et al.  Nonobvious Obstructive Meibomian Gland Dysfunction , 2010, Cornea.

[4]  T. Simpson,et al.  Human corneal adaptation to mechanical, cooling, and chemical stimuli. , 2010, Investigative ophthalmology & visual science.

[5]  Ludwik Finkelstein,et al.  Widely-defined measurement – An analysis of challenges , 2009 .

[6]  T. Simpson,et al.  Dry Eye Symptoms Assessed by Four Questionnaires , 2008, Optometry and vision science : official publication of the American Academy of Optometry.

[7]  T. Simpson,et al.  Conjunctival and corneal pneumatic sensitivity is associated with signs and symptoms of ocular dryness. , 2008, Investigative ophthalmology & visual science.

[8]  Christophe Baudouin,et al.  Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007). , 2007, The ocular surface.

[9]  Carolyn G. Begley,et al.  The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007). , 2007, The ocular surface.

[10]  Christophe Baudouin,et al.  The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). , 2007, The ocular surface.

[11]  D. Korb,et al.  The Effect of Two Novel Lubricant Eye Drops on Tear Film Lipid Layer Thickness in Subjects With Dry Eye Symptoms , 2005, Optometry and vision science : official publication of the American Academy of Optometry.

[12]  D. Korb,et al.  Lid Wiper Epitheliopathy and Dry Eye Symptoms , 2005, Eye & contact lens.

[13]  Feisal A Adatia,et al.  Correlation between corneal sensitivity, subjective dry eye symptoms and corneal staining in Sjögren's syndrome. , 2004, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[14]  Jason J Nichols,et al.  The Lack of Association Between Signs and Symptoms in Patients With Dry Eye Disease , 2004, Cornea.

[15]  Konrad Pesudovs,et al.  The Quality of Life Impact of Refractive Correction (QIRC) Questionnaire: Development and Validation , 2004, Optometry and vision science : official publication of the American Academy of Optometry.

[16]  R. Dana,et al.  Impact of dry eye syndrome on vision-related quality of life. , 2007, American journal of ophthalmology.

[17]  M. C. Acosta,et al.  Neural basis of sensation in intact and injured corneas. , 2004, Experimental eye research.

[18]  Christopher Snyder,et al.  The relationship between habitual patient-reported symptoms and clinical signs among patients with dry eye of varying severity. , 2003, Investigative ophthalmology & visual science.

[19]  J. Buring,et al.  Prevalence of dry eye syndrome among US women. , 2003, American journal of ophthalmology.

[20]  Paul Mitchell,et al.  Prevalence and associations of dry eye syndrome in an older population: the Blue Mountains Eye Study , 2003, Clinical & experimental ophthalmology.

[21]  J Lee,et al.  Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia , 2002, The British journal of ophthalmology.

[22]  G. Mitchell,et al.  Use of the Dry Eye Questionnaire to Measure Symptoms of Ocular Irritation in Patients With Aqueous Tear Deficient Dry Eye , 2002, Cornea.

[23]  Robert W Massof,et al.  The Measurement of Vision Disability , 2002, Optometry and vision science : official publication of the American Academy of Optometry.

[24]  R. Klein,et al.  Prevalence of and risk factors for dry eye syndrome. , 2000, Archives of ophthalmology.

[25]  R. Schiffman,et al.  Reliability and validity of the Ocular Surface Disease Index. , 2000, Archives of ophthalmology.

[26]  H. Taylor,et al.  The epidemiology of dry eye in Melbourne, Australia , 1998 .

[27]  B. Munoz,et al.  Prevalence of dry eye among the elderly. , 1997, American journal of ophthalmology.

[28]  D Fonn,et al.  A Patient Questionnaire Approach to Estimating the Prevalence of Dry Eye Symptoms in Patients Presenting to Optometric Practices across Canada , 1997, Optometry and vision science : official publication of the American Academy of Optometry.

[29]  L. Lin,et al.  A concordance correlation coefficient to evaluate reproducibility. , 1989, Biometrics.

[30]  M. Boeckstyns.  Development and construct validity of a knee pain questionnaire , 1987, PAIN®.

[31]  L. Guttman.  A basis for scaling qualitative data. , 1944 .

[32]  Christopher Snyder,et al.  The relative burden of dry eye in patients' lives: comparisons to a U.S. normative sample. , 2005, Investigative ophthalmology & visual science.

[33]  S. Pflugfelder,et al.  Corneal epitheliopathy of dry eye induces hyperesthesia to mechanical air jet stimulation. , 2004, American journal of ophthalmology.

[34]  C. McHorney,et al.  Postscript: Applications of Rasch analysis in health care. , 2004, Medical care.