title: Development and validation of a short global dry eye symptom index.
abstract: ABSTRACT we have developed and evaluated the repeatability of a short questionnaire based on a visual analog scale (VAS) to quantify the frequency and severity of symptoms of dry eye syndrome (DES). The "Symptom Assessment iN Dry Eye" (SANDE) questionnaire utilizes a 100 mm horizontal VAS technique to quantify patient symptoms of ocular dryness and/or irritation. Fifty-two subjects with DES were prospectively enrolled and followed-up at 2 and 4 months with repeated administrations of the SANDE questionnaire and clinical ocular surface evaluation. Subjects demonstrated a wide range of symptom scores indicative of the variability of the disease. Analyses comparing the repeatability of SANDE scores from baseline to the 2-month follow-up indicated a significant downward regression of scores toward the mean. In contrast, repeatability measures were consistently good for questionnaires administered within a few days of one another (ICC ranging from 0.53 to 0.76). Bland-Altman analysis demonstrated that 50% of repeated SANDE symptom scores were within 10 mm of each other, 80% were within 20 mm, and 95% were within less than 30 mm. These data describe good repeatability for the SANDE symptom score when repeated assessments are made within a few days. The results are encouraging and suggest that further refinement and testing of the SANDE questionnaire in larger populations may result in a reliable questionnaire to detect change in irritative symptoms over time.
authors.affiliation: Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts 02215, USA. dschaumberg@rics.bwh.harvard.edu
authors.forename: Debra A
authors.initials: DA
authors.lastname: Schaumberg
authors.forename: Abha
authors.initials: A
authors.lastname: Gulati
authors.forename: William D
authors.initials: WD
authors.lastname: Mathers
authors.forename: Thomas
authors.initials: T
authors.lastname: Clinch
authors.forename: Michael A
authors.initials: MA
authors.lastname: Lemp
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Nelson
authors.forename: Gary N
authors.initials: GN
authors.lastname: Foulks
authors.forename: Reza
authors.initials: R
authors.lastname: Dana
mesh_terms: D000368:Aged; D018450:Disease Progression; D015352:Dry Eye Syndromes / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D010147:Pain Measurement; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States