@article{Lauren M. Curtis_Manuel B. Datiles_Seth M. Steinberg_Sandra A. Mitchell_Rachel J. Bishop_Edward W. Cowen_Jacqueline Mays_John M. McCarty_Zoya Kuzmina_Filip Pirsl_Daniel H. Fowler_Ronald E. Gress_Steven Z. Pavletic_2015, place={Pavia, Italy}, title={Predictive models for ocular chronic graft-versus-host disease diagnosis and disease activity in transplant clinical practice}, volume={100}, url={https://haematologica.org/article/view/7499}, DOI={10.3324/haematol.2015.124131}, abstractNote={Ocular chronic graft-<em>versus</em>-host disease is one of the most bothersome common complications following allogeneic hematopoietic stem cell transplantation. The National Institutes of Health Chronic Graft-<em>versus</em>-Host Disease Consensus Project provided expert recommendations for diagnosis and organ severity scoring. However, ocular chronic graft-<em>versus</em>-host disease can be diagnosed only after examination by an ophthalmologist. There are no currently accepted definitions of ocular chronic graft-<em>versus</em>-host disease activity. The goal of this study was to identify predictive models of diagnosis and activity for use in clinical transplant practice. A total of 210 patients with moderate or severe chronic graft-<em>versus</em>-host disease were enrolled in a prospective, cross-sectional, observational study (<em><a href="http://clinicaltrials.gov">clinicaltrials.gov</a> identifier: 00092235</em>). Experienced ophthalmologists determined presence of ocular chronic graft-<em>versus</em>-host disease, diagnosis and activity. Measures gathered by the transplant clinician included Schirmer’s tear test and National Institutes of Health 0–3 Eye Score. Patient-reported outcome measures were the ocular subscale of the Lee Chronic Graft-<em>versus</em>-Host Disease Symptom Scale and Chief Eye Symptom Intensity Score. Altogether, 157 (75%) patients were diagnosed with ocular chronic graft-<em>versus</em>-host disease; 133 of 157 patients (85%) had active disease. In a multivariable model, the National Institutes of Health Eye Score (<em>P</em><0.0001) and Schirmer’s tear test (<em>P</em><0.0001) were independent predictors of ocular chronic graft-<em>versus</em>-host disease (sensitivity 93.0%, specificity 92.2%). The Lee ocular subscale was the strongest predictor of active ocular chronic graft-<em>versus</em>-host disease (<em>P</em><0.0001) (sensitivity 68.5%, specificity 82.6%). Ophthalmology specialist measures that were most strongly predictive of diagnosis in a multivariate model were Oxford grand total staining (<em>P</em><0.0001) and meibomian score (<em>P</em>=0.027). These results support the use of selected transplant clinician- and patient-reported outcome measures for ocular chronic graft-<em>versus</em>-host disease screening when providing care to allogeneic hematopoietic stem cell transplantation survivors with moderate to severe chronic graft-<em>versus</em&gt;-host disease. Prospective studies are needed to determine if the Lee ocular subscale demonstrates adequate responsiveness as a disease activity outcome measure.}, number={9}, journal={Haematologica}, author={Lauren M. Curtis and Manuel B. Datiles and Seth M. Steinberg and Sandra A. Mitchell and Rachel J. Bishop and Edward W. Cowen and Jacqueline Mays and John M. McCarty and Zoya Kuzmina and Filip Pirsl and Daniel H. Fowler and Ronald E. Gress and Steven Z. Pavletic}, year={2015}, month={Sep.}, pages={1228-1236} }