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A clinical decision support system for diagnosing and determining severity of dry eye disease

Eye volume 37, pages 1619–1624 (2023)Cite this article

Subjects

Abstract

Introduction

Dry eye and its related symptoms are the most common causes of referrals to the ophthalmology centers. Since people with dry eye may suffer from different levels of the disease severity, this study aimed to develop a clinical decision support system for diagnosing and determining severity of dry eye disease.

Methods

This research was carried out in two phases in 2020. In the first phase, a questionnaire was designed to identify the most important diagnostic parameters from the cornea specialists’ perspectives (n = 37). In the second phase of the research, a clinical decision support system was designed and implemented by using MATLAB software. Finally, the system was evaluated using patient data which were collected in a teaching hospital (n = 50).

Results

The diagnostic parameters for dry eye disease were filamentary keratitis, meibomian gland dysfunction, score of ocular surface disease index, Schirmer’s test result, tear meniscus height, tear breakup time, and fluorescein staining score. The system output variables were the diagnosis and severity of dry eye disease at four levels for the right and left eyes, separately. The results of the evaluation study showed that the accuracy, sensitivity and specificity of the system were 96.9%, 97.5%, and 93.7%, respectively.

Conclusion

It seems that the system designed in this study can help ophthalmologists to diagnose dry eye disease more accurately and quickly. However, it is recommended to conduct more evaluation studies and include more patients in the future research.

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Fig. 1: CDSS interface.

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Data availability

All data generated or analyzed during this study are included in this article.

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Funding

This study was funded and supported by Iran University of Medical Sciences, Tehran, Iran (IUMS/SHMIS_98-4-37-17170).

Author information

Authors and Affiliations

  1. School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

    Farzad Ebrahimi

  2. Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran

    Haleh Ayatollahi

  3. Department of Ophthalmology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Hossein Aghaei

Authors
  1. Farzad Ebrahimi
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  2. Haleh Ayatollahi
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  3. Hossein Aghaei
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Contributions

FE and HA (2nd author) conceptualized and designed the study. FE also prepared the first draft of the paper. HA (2nd author) supervised the study and commented on the paper. HA (3rd author) helped with conducting the study and commented on the paper. All authors have read and approved the paper.

Corresponding author

Correspondence to Haleh Ayatollahi.

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The authors declare no competing interests.

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Ebrahimi, F., Ayatollahi, H. & Aghaei, H. A clinical decision support system for diagnosing and determining severity of dry eye disease. Eye 37, 1619–1624 (2023). https://doi.org/10.1038/s41433-022-02197-x

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