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Fig 1.

The Berkeley Dry Eye Flow Chart (DEFC).

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Table 1.

Baseline subject characteristics.

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Table 1 Expand

Fig 2.

Difference-vs.-mean plot of DEFC scores.

The mean difference in DEFC scores (Visit 2 –Visit 1) was 0.05 units (1.00%) on the 5-point DEFC scale. There was no pattern of dependence of the inter-visit difference on the size of the mean. The discrete ordinal DEFC scores are jittered to reveal coincident data.

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Table 2.

Repeatability of the CLIDE diagnostic instruments.

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Table 3.

DEFC score vs. other CLIDE assessments.

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Table 4.

Sensitivity and specificity of CLIDE assessments for two DEFC-based diagnoses.

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Fig 3.

ROC curves for the OSDI.

For the first DEFC-based CLIDE diagnosis, the OSDI showed a low sensitivity but a relatively high specificity. For the second DEFC-based diagnosis, the sensitivity of the OSDI improved with a small concomitant reduction in specificity.

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Fig 4.

A trend of higher VAS ratings with higher DEFC score.

EOD ratings tended to be slightly higher than on-average ratings. The subjective VAS ratings had higher sensitivities and specificities than did any of the clinical measurements, and were similar to those of the OSDI. DE = Contact Lens-Induced Dry Eye (DEFC score ≥ 2); NDE = Non-DE (DEFC score = 1).

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Fig 5.

Potential pitfalls in using assessments that are significantly associated with CLIDE outcomes as diagnostic instruments.

There is clear separation between CLIDE-negative (filled circles) and CLIDE-positive (open triangles) subjects; however, there are subjects with VAS ratings above the diagnostic thresholds (No/Mild Symptoms vs. Debilitating Symptoms thresholds shown) who do not have CLIDE (false-positives), as well as those with VAS ratings below the thresholds who do have CLIDE (false-negatives).

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