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

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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 0.827to 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 favorability72% (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.
Original languageEnglish
Pages (from-to)834-843
JournalInternational Journal of Ophthalmology
Issue number6
Early online date18 Jun 2021
Publication statusEarly online date - 18 Jun 2021


  • Rasch analysis
  • dry eye disease
  • ocular surface disease index
  • test-retest reliability
  • web-based questionnaire


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