Reliability of Chinese web-based ocular surface disease index questionnaire in dry eye patients: a randomized, crossover study

Xin-Mei Zhang, Lan-Ting Yang, Qing Zhang, Qing-Xia Fan, Can Zhang, Yue You, Chen-Guang Zhang, Tie-Zhu Lin, Ling Xu, Salissou Moutari, Jonathan E Moore, Emmanuel E Pazo, Wei He, Xin-Mei Zhang, Lan-Ting Yang, Qing Zhang, Qing-Xia Fan, Can Zhang, Yue You, Chen-Guang Zhang, Tie-Zhu Lin, Ling Xu, Salissou Moutari, Jonathan E Moore, Emmanuel E Pazo, Wei He

Abstract

Aim: To assess the reliability of web-based version of ocular surface disease index in Chinese (C-OSDI) on clinically diagnosed dry eye disease (DE) patients.

Methods: A total of 254 Chinese participants (51% male, 129/254; mean age: 27.90±9.06y) with DED completed paper- and web-based versions of C-OSDI questionnaires in a randomized crossover design. Ophthalmology examination and DED diagnosis were performed prior to the participants being invited to join the study. Participants were randomly designated to either group A (paper-based first and web-based second) or group B (web-based first and paper-based second). Final data analysis included participants that had successfully completed both versions of the C-OSDI. Demographic characteristics, test-retest reliability, and agreement of individual items, subscales, and total score were evaluated with intraclass correlation coefficients (ICC), Spearman rank correlation, Wilcoxon test and Rasch analysis.

Results: Reliability indexes were adequate, Pearson correlation was greater than 0.8 and ICCs range was 0.827 to 0.982; total C-OSDI score was not statistically different between the two versions. The values of mean-squares fit statistics were very low compared to 1, indicating that the responses to the items by the model had a high degree of predictability. While comparing the favorability 72% (182/254) of the participants preferred web-based assessment.

Conclusion: Web-based C-OSDI is reliable in assessing DED and correlation with the paper-based version is significant in all subscales and overall total score. Web-based C-OSDI can be administered to assess individuals with DED as participants predominantly favored online assessment.

Keywords: Rasch analysis; dry eye disease; ocular surface disease index; test-retest reliability; web-based questionnaire.

International Journal of Ophthalmology Press.

Figures

Figure 1. Study flow diagram.
Figure 1. Study flow diagram.
Figure 2. Screenshot of web-based C-OSDI version.
Figure 2. Screenshot of web-based C-OSDI version.
Figure 3. Boxplot distribution of web-based and…
Figure 3. Boxplot distribution of web-based and paper-based C-OSDI total scores.
Figure 4. Bland-Altman analysis for clinical agreement…
Figure 4. Bland-Altman analysis for clinical agreement between the web-based C-OSDI and paper-based C-OSDI final scores revealed a clinical difference (bias) of -0.25 units.
Figure 5. Correlation between web-based and paper-based…
Figure 5. Correlation between web-based and paper-based OSDI total scores.
Figure 6. Items characteristic curves of web-based…
Figure 6. Items characteristic curves of web-based C-OSDI items.
Figure 7. Items characteristic curves of paper-based…
Figure 7. Items characteristic curves of paper-based C-OSDI items.

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