Validation of the 5-Item Dry Eye Questionnaire (DEQ-5): Discrimination across self-assessed severity and aqueous tear deficient dry eye diagnoses

• Published in: Contact lens & anterior eye 2010-04, Vol.33 (2), p.55-60
• Main Authors: Chalmers, Robin L, Begley, Carolyn G, Caffery, Barbara
• Format: Article
• Language: English
• Subjects: Adult; DEQ-5; Diagnostic Techniques, Ophthalmological - statistics & numerical data; Dry eye; Dry Eye Syndromes - diagnosis; Dry Eye Syndromes - epidemiology; Female; Humans; Male; Middle Aged; Ophthalmology; Prevalence; Questionnaire; Reproducibility of Results; Screening; Sensitivity and Specificity; Severity of Illness Index; Sjogren's syndrome; Surveys and Questionnaires; Symptoms; United States - epidemiology
• ISSN: 1367-0484; 1476-5411
• DOI: 10.1016/j.clae.2009.12.010

Abstract Purpose To validate a subset of Dry Eye Questionnaire (DEQ) items that discriminate across self-assessed severity and various diagnoses of dry eye (DE). Methods Subjects ( n = 260) in 2 studies received a clinical DE diagnosis, completed the 6-page DEQ and self-assessment of DE severity (SA-Sev). SA-Sev ratings were: 46 Severe, 107 Moderate, 77 Mild, and 46 None. Dry eye diagnoses were: 48 asymptomatic controls (C), 155 non-SS KCS, and 57 Sjögren Syndrome (SS). All DEQ items were correlated to SA-Sev by Spearman. Groups of highly correlated DEQ items were tested to discriminate SA-Sev; and the subset tested to distinguish across DE diagnosis. Results The DEQ-5 comprises: frequency of watery eyes ( r = 0.48), discomfort ( r = 0.41), and dryness ( r = 0.35), and late day (PM) intensity of discomfort and dryness ( r = 0.42, 0.36) all significantly correlated to SA-Sev ( p < 0.01). Mean DEQ-5 scores by SA-Sev: Severe 14.9 ± 2.3, Moderate 11.4 ± 3.3, Mild 8.6 ± 3.1 and None 2.7 ± 3.2 (ANOVA, p < 0.0001) and by DE diagnosis: C 2.7 ± 2.9, non-SS KCS10.5 ± 4.5 and SS14.0 ± 3.4, differing significantly overall ( Z = −8.6, p = 0.000) and between diagnoses ( X2 = 116.3, p = 0.000). Watery eyes were reported primarily by non-SS KCS. Proposed screening criteria for the DEQ-5 are >6 for DE and >12 for suspected SS. Conclusions The DEQ-5, the sum of scores for frequency and PM intensity of dryness and discomfort plus frequency of watery eyes, effectively discriminated across self-assessed severity ratings and between patients with DE diagnoses. These results indicate that DEQ-5 scores >6 suggest DE and scores >12 may indicate further testing to rule out SS–DE.