Accuracy of McMonnies Questionnaire as a Screening Tool for Chinese Ophthalmic Outpatients

OBJECTIVE To evaluate the accuracy of the McMonnies questionnaire (MQ) as a screening tool for dry eye (DE) among Chinese ophthalmic outpatients. METHODS We recruited 27718 cases from 94 hospitals (research centers), randomly selected from 45 cities in 23 provinces from July to November in 2013. Only symptomatic outpatients were included and they were in a high risk of DE. Outpatients meeting the criteria filled out questionnaires and then underwent clinical examinations by qualified medical practitioners. We mainly evaluated sensitivity, specificity, diagnostic odds ratio (DOR), and area under the receiver-operating characteristic curve (AUC) to evaluate the accuracy of the questionnaire in the diagnosis of dry eye. RESULTS Of all the subjects included in the study, sensitivity, specificity, and DOR were 0.77, 0.86 and 20.6, respectively. AUC was 0.865 with a 95% CI (0.861, 0.869). The prevalence of DE among the outpatients claiming "constantly" as the frequency of symptom was over 90%. Scratchiness was a more accurate diagnostic indication than dryness, soreness, grittiness or burning. Different cut points of McMonnies Index (MI) scores can be utilized to optimize the screening results. CONCLUSIONS MQ can be an effective screening tool for dry eye. We can take full advantage of MI score during the screening process.