Diagnostic Performance of McMonnies Questionnaire as a Screening Survey for Dry Eye: A Multicenter Analysis

Abstract EN

Purpose.

To evaluate the diagnostic performance of the McMonnies questionnaire as a screening survey for dry eye in Chinese outpatients.

Methods.

The questionnaire was self-administered by 27,999 patients with dry eye symptoms.

A thorough ophthalmic examination including tear break-up time (TBUT), fluorescein staining, and Schirmer I test was completed to make a clinical diagnosis of dry eye.

Reliability, validity, and accuracy of the McMonnies questionnaire were assessed.

Results.

The McMonnies questionnaire showed poor internal consistency (Cronbach α = 0.37 ), but excellent validity as the scores correlated with TBUT (Spearman test, r = - 0.322 , P < 0.001 ) and Schirmer I test (Spearman’s test, r = - 0.370 , P < 0.001 ), and significantly differed between the dry eye and control groups (2-sample t-test, t = 69.51 , P < 0.001 ).

The area under the receiver-operating characteristics (ROC) curve (AUC) was 0.729, suggesting moderate accuracy in identifying dry eye and non-dry eye patients.

However, the AUCs varied significantly in different gender and age subgroups (z test, P < 0.001 ), as the discriminating ability declined with age.

Analysis of the ROC curves also revealed that different cut-off points should be employed for each subgroup to achieve the same level of accuracy.

Conclusions.

The McMonnies questionnaire demonstrates moderate diagnostic value, and different cut-off points should be selected for various study populations.