Digital Implementation And Validation Of A Qr-Based Turkish Osdi-6 For Clinical Dry Eye Assessment

To develop and evaluate a digitally integrated Turkish version of the Ocular Surface Disease Index-6 (OSDI-6) and assess its reliability, concurrent validity with OSDI-12, and association with non-invasive tear film parameters.

Koç University Hospital, Department of Ophthalmology, Istanbul, Turkey

In this prospective study the OSDI-6 was forward-translated into Turkish and implemented as a QR-based web application with automated scoring and standardized real-time data capture. This system was developed with artificial intelligence-assisted programming support. Consecutive patients undergoing non-invasive dry eye evaluation completed the digital OSDI-6. A subset also completed the validated Turkish OSDI-12. Non-invasive tear break-up time (NIBUT) was measured bilaterally using the same device and averaged per patient. Oxford corneal staining grades and conjunctival vasodilation (Oculus) scores were recorded. Internal consistency was assessed using Cronbach’s alpha and correlations were analyzed using Spearman correlation coefficients.

Eighteen patients completed item-level OSDI-6 assessments. Mean OSDI-6 score was 7 ± 5.93 and mean OSDI-12 score was 13.25 ± 11.62. Internal consistency was excellent (Cronbach’s α = 0.882). OSDI-6 demonstrated strong concurrent validity with OSDI-12 (ρ = 0.92, p < 0.001). Mean NIBUT was 8.33 ± 2.25 seconds. OSDI-6 showed weak correlation with mean NIBUT (Spearman ρ = 0.33, p = 0.21).

The QR-based digitally integrated Turkish OSDI-6 demonstrated excellent reliability and strong concurrent validity with OSDI-12. The weak association with tear film stability is consistent with the well-recognized signs-symptoms discordance in dry eye disease. The electronically implemented OSDI-6 may serve as a standardized and efficient symptom-screening tool for routine clinical dry eye assessment and longitudinal follow-up.