ORIGINAL RESEARCH article
Front. Med.
Sec. Family Medicine and Primary Care
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1552781
This article is part of the Research TopicThe Increasing Relevance of Traditional Medicine Systems for the Primary Health Care Sector and General Practice: Global Research Perspectives – Volume IIView all 12 articles
Diagnostic Value of Tongue Manifestations for Primary Sjögren's Syndrome: Construction and Validation of Disease Screening Model
Provisionally accepted- 1Beijing University of Chinese Medicine, Beijing, China
- 2China-Japan Friendship Hospital, Beijing, Beijing Municipality, China
- 3Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, Beijing Municipality, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: Tongue manifestations (tongue fur and tongue body) of traditional Chinese medicine is specific for primary Sjögren's syndrome (pSS). We investigated the value of tongue manifestations in the diagnosis of pSS and established a model for screening or diagnosing pSS. Methods: A total of 400 individuals attended at the China-Japan Friendship Hospital were included in this study. 200 patients with pSS and 200 healthy individuals were randomly divided into training and test sets (7:3 ratio). The training set was used to build models based on combined tongue, tongue fur, and tongue body, respectively, and the optimal model was selected through model discrimination and calibration. The optimal model is internally validated using the bootstrap method and further performed on the test set to assess transportability and generalisability. Receiver operating characteristic curve, calibration curve, Brier score, and decision curve analysis (DCA) were used to evaluate the performance of the model. Results: In the training set, we identified an optimal model which included sex, age, bluish-purple tongue, thin tongue, fissured tongue, thin fur, and peeling fur, after evaluating and comparing three models. The model demonstrated an area under the curve (AUC) of 0.89, and the lowest Brier score of 0.13, with well-fitted calibration curves. The optimal cut-off value for the model is 0.347, with sensitivity and specificity of 87.86% and 76.43%, respectively. The model also shows well discrimination in internal validation. In the test set, this model demonstrated an AUC of 0.93 and with a Brier score of 0.11, and sensitivity and specificity of 93.33% and 71.67%, respectively. A nomogram for pSS screening was developed based on the model.Conclusion: The non-invasive, reliable and convenient model, established based on age and sex of the patient and specific tongue manifestations can serve as a clinical reference tool for screening or diagnosing of pSS.
Keywords: Sjögren's syndrome, Tongue, Traditional Chinese Medicine, Screening model, diagnosis
Received: 29 Dec 2024; Accepted: 28 Apr 2025.
Copyright: © 2025 Chen, Zhang, Liao, Yang, Jiang, Huang, TzuHua, ZHANG, Wang, Lei, Zhang, Luo and Tao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jing Luo, China-Japan Friendship Hospital, Beijing, 100029, Beijing Municipality, China
Qingwen Tao, China-Japan Friendship Hospital, Beijing, 100029, Beijing Municipality, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.