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Subjects were categorized into three groups: Group (1) DED based on Dry Eye Workshop-II (DEWS-II): Ocular Surface Disease Index (OSDI)\u2009\u2265\u200913 and at least one abnormal clinical sign (non-invasive tear break-up time [NIBUT]\u2009&lt;\u200910\u00a0s, osmolarity\u2009&gt;\u2009308 mOsm\/L, or corneal\/conjunctival staining). Group (2) DED based on criteria used in prior clinical trials: OSDI\u2009&gt;\u200913, Schirmer\u2009&lt;\u200910\u00a0mm in 5\u00a0min, NIBUT\u2009&lt;\u200910\u00a0s, and keratoconjunctival staining. Group (3) Healthy controls: OSDI\u2009\u2264\u20097, NIBUT\u2009\u2265\u200910\u00a0s, Schirmer\u2009<jats:italic>\u2265<\/jats:italic>\u200910\u00a0mm, and no keratoconjunctival staining. DED severity was classified using the ODISSEY European Consensus Group\u2019s definitions into severe and non-severe. Sensitivity, specificity, and predictive values were calculated for both criteria.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>1,363 patients were included in Group 1, 401 in Group 2, and 152 in Group 3. Sensitivity was 81.30% in the population diagnosed using previous clinical trial criteria but decreased to 69.99% when applying the DEWS-II criteria. Specificity was 38.16% in both groups, with 409\/467 false negatives\u00a0respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>InflammaDry shows good sensitivity in detecting DED in highly symptomatic cases with multiple clinical signs, but its performance decreases when broader criteria like DEWS-II are used. While valuable for detecting inflammation, routine use for DED diagnosis may lead to false negatives, especially in milder cases.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00417-025-06760-6","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T02:48:57Z","timestamp":1741142937000},"page":"1623-1631","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Real-world performance of the inflammadry test in dry eye diagnosis: an analysis of 1,515 patients"],"prefix":"10.1007","volume":"263","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1241-0715","authenticated-orcid":false,"given":"Germ\u00e1n","family":"Mej\u00eda-Salgado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-8989","authenticated-orcid":false,"given":"William","family":"Rojas-Carabali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2703-0977","authenticated-orcid":false,"given":"Carlos","family":"Cifuentes-Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0295-4986","authenticated-orcid":false,"given":"Laura","family":"Z\u00e1rate-Pinz\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo Andr\u00e9s","family":"Rodr\u00edguez-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Marroqu\u00edn-G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha Luc\u00eda","family":"Moreno-Pardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Tirado-\u00c1ngel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0684-1989","authenticated-orcid":false,"given":"Alejandra","family":"de-la-Torre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"6760_CR1","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.jtos.2017.05.008","volume":"15","author":"JP Craig","year":"2017","unstructured":"Craig JP, Nichols KK, Akpek EK et al (2017) TFOS DEWS II definition and classification report. 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