{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T21:29:27Z","timestamp":1771536567834,"version":"3.50.1"},"reference-count":52,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI18\/00374"],"award-info":[{"award-number":["PI18\/00374"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Regional Development Fund","award":["PI18\/00374"],"award-info":[{"award-number":["PI18\/00374"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The Ocular Comfort Index (OCI) assesses ocular surface irritation and grades the severity of dry eye disease. This study sought to adapt the OCI questionnaire into Spanish, and then to assess the psychometric performance and validity of the new adapted version (OCI-versi\u00f3n espa\u00f1ola, OCIVE). The questionnaire was translated, back translated, and then cross-culturally adapted for use with Spanish-speaking individuals. The OCIVE was completed by 450 participants, including 53 subjects that were diagnosed with dry eye disease. Through a Rasch analysis, the psychometric properties of item fit, targeting, person separation, reliability, and differential item functioning (DIF) were assessed. To test the convergent validity, we examined the correlation between the OCIVE and the Computer Vision Symptom Scale (CVSS17). Validity was tested in a subgroup of participants with and without dry eye, and test-retest repeatability was determined in a subset of 151 individuals. We also compared, via DIF, the performance of the OCIVE with that of the original OCI. Our Rasch analysis revealed a good model fit, high accuracy, good targeting, unidimensionality, and no DIF according to gender. The validity and repeatability were good. The OCIVE shows comparable psychometric properties to the original English version, making it a valid tool for measuring dry eye symptoms in Spanish adults.<\/jats:p>","DOI":"10.3390\/ijerph192215142","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T03:12:20Z","timestamp":1668654740000},"page":"15142","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Spanish Cross-Cultural Adaptation, Rasch Analysis and Validation of the Ocular Comfort Index (OCI) Questionnaire"],"prefix":"10.3390","volume":"19","author":[{"given":"Ana Rosa","family":"Barrio","sequence":"first","affiliation":[{"name":"Optics and Optometry Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"},{"name":"Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5967-5000","authenticated-orcid":false,"given":"Mariano","family":"Gonz\u00e1lez-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Optics and Optometry Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Heredia-Pastor","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8816-6360","authenticated-orcid":false,"given":"Jacobo","family":"Enr\u00edquez-Fuentes","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Antona","sequence":"additional","affiliation":[{"name":"Optics and Optometry Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"},{"name":"Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/j.jtos.2017.08.003","article-title":"TFOS DEWS II Report Executive Summary","volume":"15","author":"Craig","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jtos.2017.05.003","article-title":"TFOS DEWS II Epidemiology Report","volume":"15","author":"Stapleton","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1167\/iovs.09-3448","article-title":"Activities of daily vision scale: What do the subscales measure?","volume":"51","author":"Gothwal","year":"2010","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1136\/bjophthalmol-2012-301767","article-title":"Prevalence and predictors of Sj\u00f6gren\u2019s syndrome in a prospective cohort of patients with aqueous-deficient dry eye","volume":"96","author":"Liew","year":"2012","journal-title":"Br. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"23412","DOI":"10.1038\/s41598-021-02738-6","article-title":"Meibomian gland dysfunction is highly prevalent among first-time visitors at a Norwegian dry eye specialist clinic","volume":"11","author":"Badian","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1097\/01.opx.0000232814.39651.fa","article-title":"The Features of Dry Eye Disease in a Japanese Elderly Population","volume":"83","author":"Uchino","year":"2006","journal-title":"Optom. Vis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1016\/j.ophtha.2008.06.022","article-title":"Prevalence of dry eye disease among Japanese visual display terminal users","volume":"115","author":"Uchino","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/aos.15049","article-title":"The association between visual display terminal use and dry eye: A review","volume":"100","author":"Fjaervoll","year":"2022","journal-title":"Acta Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/cxo.12210","article-title":"Prevalence of and risk factors for symptomatic dry eye disease in Singapore","volume":"98","author":"Tan","year":"2015","journal-title":"Clin. Exp. Optom."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1016\/j.ophtha.2011.05.029","article-title":"Prevalence and Risk Factors of Dry Eye Disease in Japan: Koumi Study","volume":"118","author":"Uchino","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.ajo.2013.12.023","article-title":"Dry Eye in the Beaver Dam Offspring Study: Prevalence, Risk Factors, and Health-Related Quality of Life","volume":"157","author":"Paulsen","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1159\/000027401","article-title":"Eye discomfort and air pollution","volume":"213","author":"Versura","year":"1999","journal-title":"Ophthalmologica"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.envres.2010.03.003","article-title":"The effects of chronic exposure to traffic derived air pollution on the ocular surface","volume":"110","author":"Novaes","year":"2010","journal-title":"Environ. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s40557-014-0026-z","article-title":"Prevalence of dry eye syndrome after a three-year exposure to a clean room","volume":"26","author":"Cho","year":"2014","journal-title":"Ann. Occup. Environ. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/j.ophtha.2013.11.036","article-title":"Environmental factors affect the risk of dry eye syndrome in a United States veteran population","volume":"121","author":"Galor","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1089\/ham.2007.1055","article-title":"Prevalence of dry eye at high altitude: A case controlled comparative study","volume":"9","author":"Gupta","year":"2008","journal-title":"High Alt. Med. Biol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1016\/S0161-6420(97)30125-0","article-title":"Relation between signs and symptoms of dry eye in the elderly: A population-based perspective","volume":"104","author":"Schein","year":"1997","journal-title":"Ophthalmology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4753","DOI":"10.1167\/iovs.03-0270","article-title":"The Relationship between Habitual Patient-Reported Symptoms and Clinical Signs among Patients with Dry Eye of Varying Severity","volume":"44","author":"Begley","year":"2003","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1097\/01.ico.0000133997.07144.9e","article-title":"The Lack of Association Between Signs and Symptoms in Patients With Dry Eye Disease","volume":"23","author":"Nichols","year":"2004","journal-title":"Cornea"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S1542-0124(12)70081-2","article-title":"The definition and classification of dry eye disease: Report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop","volume":"5","author":"Lemp","year":"2007","journal-title":"Ocul. Surf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1097\/01.ico.0000154410.99691.3c","article-title":"The agreement between self-assessment and clinician assessment of dry eye severity","volume":"24","author":"Chalmers","year":"2005","journal-title":"Cornea"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/01.ICL.0000140907.45705.E2","article-title":"The diagnosis and characteristics of moderate dry eye in non-contact lens wearers","volume":"31","author":"Narayanan","year":"2005","journal-title":"Eye Contact Lens"},{"key":"ref_23","first-page":"581","article-title":"Diagnosis of dry eye disease and emerging technologies","volume":"8","author":"Zeev","year":"2014","journal-title":"Clin. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Okumura, Y., Inomata, T., Iwata, N., Sung, J., Fujimoto, K., Fujio, K., Midorikawa-Inomata, A., Miura, M., Akasaki, Y., and Murakami, A. (2020). A review of dry eye questionnaires: Measuring patient-reported outcomes and health-related quality of life. Diagnostics, 10.","DOI":"10.3390\/diagnostics10080559"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"U.S. Department of Health and Human Services FDA Center for Drug Evaluation and Research, U.S. Department of Health and Human Services FDA Center for Biologics Evaluation and Research, and U.S. Department of Health and Human Services FDA Center for Devices and Radiological Health (2006). Guidance for industry: Patient-reported outcome measures: Use in medical product development to support labeling claims: Draft guidance. Health Qual. Life Outcomes, 4, 79.","DOI":"10.1186\/1477-7525-4-79"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4451","DOI":"10.1167\/iovs.06-1253","article-title":"Measurement of ocular surface irritation on a linear interval scale with the ocular comfort index","volume":"48","author":"Johnson","year":"2007","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1097\/OPX.0000000000000001","article-title":"Quality assessment of ophthalmic questionnaires: Review and recommendations","volume":"90","author":"Khadka","year":"2013","journal-title":"Optom. Vis. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jtos.2017.01.005","article-title":"Rasch analysis of three dry eye questionnaires and correlates with objective clinical tests","volume":"15","author":"McAlinden","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3562","DOI":"10.1167\/iovs.14-14276","article-title":"Development of a Chinese version of the ocular comfort index","volume":"55","author":"Chao","year":"2014","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_30","unstructured":"Pastor, C. (2022). El espa\u00f1ol en el mundo. Anuario del Instituto Cervantes 2022, Instituto Cervantes."},{"key":"ref_31","unstructured":"Wu, M., and Adams, R.J. (2007). Applying the Rasch Model to Psycho-Social Measurement: A Practical Approach, Educational Measurement Solutions."},{"key":"ref_32","unstructured":"(2022, November 08). Prolific What Is Prolific and How does It Work?. Available online: https:\/\/participant-help.prolific.co\/hc\/en-gb\/articles\/360022523613-What-is-Prolific-and-how-does-it-work-."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Gjersing, L., Caplehom, J.R., and Clausen, T. (2018). Cross-cultural adaptation of research instruments: Language, setting, time and statistical considerations. BMC Med. Res. Methodol., 10.","DOI":"10.1186\/1471-2288-10-13"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the process of cross-cultural adaptation of self-report measures","volume":"25","author":"Beaton","year":"2000","journal-title":"Spine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/j.1524-4733.2005.04054.x","article-title":"Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR task force for translating adaptation","volume":"8","author":"Wild","year":"2005","journal-title":"Value Health"},{"key":"ref_36","unstructured":"Linacre, J.M. (2020). Winsteps\u00ae Rasch Measurement Computer Program User\u2019s Guide, Winsteps.com."},{"key":"ref_37","first-page":"571","article-title":"Rating scales and Rasch measurement","volume":"11","author":"Andrich","year":"2011","journal-title":"Pharm. Outcomes Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1167\/iovs.11-8102","article-title":"Establishing levels of indications for cataract surgery: Combining clinical and questionnaire data into a measure of cataract impact","volume":"53","author":"McAlinden","year":"2012","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1111\/j.1475-1313.2004.00202.x","article-title":"Validity and realiability of the revised convergence insifficiency symptom survey in adults","volume":"24","author":"Rouse","year":"2004","journal-title":"Opthalmic Physiol. Opt."},{"key":"ref_40","first-page":"328","article-title":"Sample Size and Item Calibration Stability","volume":"7","author":"Linacre","year":"1994","journal-title":"Rasch Meas. Trans."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4504","DOI":"10.1167\/iovs.13-13818","article-title":"The Computer-Vision Symptom Scale (CVSS17): Development and initial validation","volume":"55","author":"Susi","year":"2014","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1038\/eye.1997.161","article-title":"The Doyne Lecture reflections on the tears","volume":"11","author":"Bron","year":"1997","journal-title":"Eye"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"327","author":"Bland","year":"1986","journal-title":"Lancet"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1167\/iovs.06-0361","article-title":"The impact of vision impairment questionnaire: An assessment of its domain structure using confirmatory factor analysis and rasch analysis","volume":"48","author":"Lamoureux","year":"2007","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1097\/OPX.0b013e318141fe75","article-title":"The development Assessment, and selection of questionnaires","volume":"84","author":"Pesudovs","year":"2007","journal-title":"Optom. Vis. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/1477-7525-10-80","article-title":"The importance of rating scales in measuring patient-reported outcomes","volume":"10","author":"Khadka","year":"2012","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"McNeely, R.N., Moutari, S., Arba-Mosquera, S., Verma, S., and Moore, J.E. (2018). An alternative application of Rasch analysis to assess data from ophthalmic patient-reported outcome instruments. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197503"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-P\u00e9rez, M., Susi, R., Barrio, A., and Antona, B. (2018). Five levels of performance and two subscales identified in the computer-vision symptom scale (CVSS17) by Rasch, factor, and discriminant analysis. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0202173"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1207\/S15327752JPA8001_18","article-title":"Starting at the beginning: An introduction to coefficient alpha and internal consistency","volume":"80","author":"Streiner","year":"2003","journal-title":"J. Personal. Assess."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"5537","DOI":"10.1167\/iovs.10-5341","article-title":"The development of an instrument to measure quality of vision: The quality of vision (QoV) questionnaire","volume":"51","author":"McAlinden","year":"2010","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1097\/00003226-200108000-00011","article-title":"Characterization of ocular surface symptoms from optometric practices in North America","volume":"20","author":"Begley","year":"2001","journal-title":"Cornea"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09286586.2016.1246667","article-title":"Validating Translations of Rating Scale Questionnaires Using Rasch Analysis","volume":"24","author":"Bradley","year":"2017","journal-title":"Ophthalmic Epidemiol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/22\/15142\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:19:51Z","timestamp":1760145591000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/22\/15142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,17]]},"references-count":52,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["ijerph192215142"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192215142","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,17]]}}}