Evidence map›Paper›PMID 39079754›Full record

Trial reportCornea2025

Intereye Agreement in Dry-Eye Signs in the DREAM Study: Implications for Future Dry-Eye Trials.

Anny Zhong, Patrick Augello, Penny Asbell, Gui-Shuang Ying, DREAM Study Research Group

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Cornea, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Dynamic Tear Film Stability Assessed via an Open-View Double-Pass Imaging System.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026
    Article
  2. The repeatability of tests for dry eye signs and symptoms in the dry eye assessment and management (DREAM) study.Contact lens & anterior eye : the journal of the British Contact Lens Association · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anny ZhongPerelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
Patrick AugelloCenter for Preventive Ophthalmology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; and.
Penny AsbellUniversity of Memphis, Memphis, TN.
Gui-Shuang YingPerelman School of Medicine at University of Pennsylvania, Philadelphia, PA.ORCID 0000-0002-5752-1355
DREAM Study Research Group

Funding

The Dry Eye Evaluation And Management (DREAM) Study: Coordinating CenterU10EY022879 · NEI · UNIVERSITY OF PENNSYLVANIA · PI MAGUIRE, MAUREEN G · 2013 to 2018
$7.3M
Dry Eye Evaluation and Management (DREAM) StudyU10EY022881 · NEI · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI ASBELL, PENNY · 2013 to 2020
$2.2M
Developing new methods for early detection of Sjogren's syndromeR01EY026972 · NEI · UNIVERSITY OF PENNSYLVANIA · PI BUNYA, VATINEE Y · 2016 to 2020
$2.0M
Secondary Analysis of Data from the Dry Eye Assessment and Management (DREAM) StudyR21EY031338 · NEI · UNIVERSITY OF PENNSYLVANIA · PI YING, GUI-SHUANG · 2020 to 2021
$448k
National Institute of Health U10EY022879, U10EY022881, R21EY031338, R01EY026972NEI NIH HHS R01 EY026972NEI NIH HHS R21 EY031338NEI NIH HHS U10 EY022879NEI NIH HHS U10 EY022881
6 · The paper itself

Abstract

purposeTo investigate intereye agreement in dry-eye disease (DED) signs in the Dry Eye Assessment and Management study.

methodsTear break-up time (TBUT), Schirmer test, conjunctival staining, corneal staining, meibomian gland dysfunction (MGD), and tear osmolarity were measured at baseline, 3, 6, and 12 months. Intereye agreement was assessed by intraclass correlation coefficient, weighted kappa, and percentage of participants with absolute intereye difference (AID) exceeding a clinically significant threshold (2 points for conjunctival staining and MGD, 2 seconds for TBUT, 3 points for corneal staining, 5 mm/5 minutes for Schirmer test, and 8 mOsms/L for osmolarity). The worse eye at each visit for each DED sign was determined as the eye with a sign worse than the contralateral eye by at least the clinically significant threshold.

resultsDED signs had moderate-to-good intereye agreement with intraclass correlation coefficient ranging from 0.45 (tear osmolarity) to 0.81 (corneal staining and Schirmer test) and weighted kappa from 0.58 (plugging) to 0.69 (lid secretion). Percentage of participants exceeding threshold AID was 15% to 20% for conjunctival staining, 11% to 15% for TBUT, 17% to 21% for MGD, 13% to 18% for corneal staining, 21% to 23% for Schirmer test, and 44% to 47% for osmolarity. The eye with a worse DED sign ranged between 36% (TBUT) and 80% (osmolarity) of participants.

conclusionsParticipants demonstrated moderate-to-good intereye agreement, yet a substantial portion showed clinically significant intereye differences in each sign. The worse eye was not the same eye in the majority during follow-up. These findings suggest considering signs from both eyes in future DED trials.

Indexed as

ConjunctivaDry Eye SyndromesTearsAdultAgedCorneaDiagnostic Techniques, OphthalmologicalFemaleHumansMaleMeibomian Gland DysfunctionMiddle AgedOsmolar ConcentrationReproducibility of Results

Identifiers

PMID39079754
PMCPMC11717632

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.