title: Validation of the 5-Item Dry Eye Questionnaire (DEQ-5): Discrimination across self-assessed severity and aqueous tear deficient dry eye diagnoses.
abstract: OBJECTIVE
  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 (X(2)=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.
authors.affiliation: Indiana University, Bloomington, USA. chalmers2097@gmail.com
authors.forename: Robin L
authors.initials: RL
authors.lastname: Chalmers
authors.forename: Carolyn G
authors.initials: CG
authors.lastname: Begley
authors.forename: Barbara
authors.initials: B
authors.lastname: Caffery
mesh_terms: D000328:Adult; D003941:Diagnostic Techniques, Ophthalmological / Q000706:statistics & numerical data*; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology