Reliability, Accuracy, and Use Frequency of Evaluation Methods for Amount of Tongue Coating

Kim, Su-Ryun; Nam, Dong Hyun

doi:10.1007/s11655-018-2552-y

Cited by 6 publications

(5 citation statements)

References 111 publications

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“…TCT is a term used to represent the degree of tongue coating in accordance with the amount of tongue coating in TKM. [5] TCT evaluation methods can be categorized as intuitive and objective. The intuitive methods use naked eye observations to classify TCT into 3 to 5 grades according to the severity [7,29–31] or distribution area of tongue coating.…”

Section: Discussionmentioning

confidence: 99%

“…In a systematic review of the TCT evaluation methods, weighing method was set as a gold standard in order to assess the accuracy of the other methods. [5] Recently, criteria for differentiation were developed through analyses of the consistency between the results obtained by well-trained clinicians and those based on the distribution area of tongue coating on the dorsum. [6] However, the area method cannot be expected to be highly accurate because it does not take into account the thickness of the tongue coating.…”

Section: Discussionmentioning

confidence: 99%

“…To date, various methods have been used for the evaluation of TCT. [5] The conventional method used widely in TKM and TCM involves the classification of TCT into 3 categories on the basis of naked eye observations and the intuitive judgment of practitioners: no coating, thin coating, and thick coating. [6,7] Other proposed methods include quantitative estimation of tongue coating via assessment of the degree of visibility of the pink tongue body or tongue coating discoloration.…”

Section: Introductionmentioning

confidence: 99%

“…[12] Nevertheless, this method of weighing the tongue coating has been regarded as the most suitable approach because it is the most direct and feasible method. [5]…”

Section: Introductionmentioning

confidence: 99%

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Association between tongue coating thickness and ultraviolet fluorescence in patients with functional dyspepsia

Kim

Yeo

et al. 2019

Medicine

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The aim of this study was to examine the correlation between the tongue coating thickness (TCT) and ultraviolet (UV) fluorescence and propose a new method for the estimation of TCT using a computerized tongue image acquisition system (CTIS). In this prospective and observational single-center study, we acquired tongue images under visible light and near-UV light for 60 patients with functional dyspepsia. Tongue images were acquired twice within a 30-minute interval to assess the reliability of CTIS. Then, the tongue coating was scraped and weighed to derive the wet weight of the tongue coating (WWTC). The percentage of the tongue coating area was calculated from the tongue images acquired under visible light. Mean color values (mCVs) for the UV fluorescence of the dorsal surface of the tongue were also computed. The reliabilities of the derived mCVs and percentage of the tongue coating area were acceptable (intraclass correlation coefficients, 0.907–0.947). The mCVs were more strongly correlated with WWTC than with the area, with mCV of modified lightness showing the strongest association ( r = 0.785, P < .01). Finally, we suggested an estimation model for TCT based on the results. The results of this study suggest that both UV fluorescence of the dorsal tongue and the distribution area of tongue coating are useful parameters for the quantitative assessment of tongue coating. We believe that these findings will contribute to the development of a clinically useful CTIS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…[12] Nevertheless, this method of weighing the tongue coating has been regarded as the most suitable approach because it is the most direct and feasible method. [5]…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association between tongue coating thickness and ultraviolet fluorescence in patients with functional dyspepsia

Kim

Yeo

et al. 2019

Medicine

Self Cite

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“…Excel 2021 (Microsoft, Redmond, USA) and SPSS 21.0 (IBM, Chicago, IL, USA) were used to analyze the data. Pearson’s method [ 35 ] for correlation analysis was performed by the Genescloud platform (Personalbio, Shanghai, China). Data were presented as means ± standard deviations (SD) of at least three independent experiments; each experiment had a minimum of three replicates of each sample.…”

Section: Methodsmentioning

confidence: 99%

Changes of Bioactive Components and Antioxidant Capacity of Pear Ferment in Simulated Gastrointestinal Digestion In Vitro

Zhang

et al. 2023

Foods

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Fruit ferment is rich in polyphenols, organic acids, enzymes, and other bioactive components, which contribute to their antioxidant ability. In this study, we investigated the effect of the simulated gastric and intestinal digestion in vitro on the total phenolic content (TPC), total flavonoid content (TFC), phenolic components content, organic acid content, protease activity, superoxide dismutase (SOD) activity, 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity (DPPH-RSA), hydroxyl (·OH) radical scavenging activity (·OH-RSA), and total reducing capacity in ‘Xuehua’ pear (Pyrus bretschneideri Rehd) ferment. The result showed that the TPC, TFC, protease activity, and phenolic components such as arbutin, protocatechuic acid, malic acid, and acetic acid showed a rising trend during the simulated gastric digestion in ‘Xuehua’ pear ferment, and these components might contribute to the increasing of ·OH-RSA and total reducing capacity. The SOD activity and epicatechin content showed an increasing trend at first and then a decreasing trend, which was likely associated with DPPH-RSA. During in vitro-simulated intestinal digestion, the majority of evaluated items reduced, except for protease activity, quercetin, and tartaric acid. The reason for the decreasing of bio-accessibility resulted from the inhibition of the digestive environment, and the transformation between substances, such as the conversion of hyperoside to quercetin. The correlation analysis indicated that the antioxidant capacity of ‘Xuehua’ pear ferment was mainly affected by its bioactive compounds and enzymes activity as well as the food matrices and digestive environment. The comparison between the digestive group with and without enzymes suggested that the simulated gastrointestinal digestion could boost the release and delay the degradation of phenolic components, flavonoids, and organic acid, protect protease and SOD activity, and stabilize DPPH-RSA, ·OH-RSA, and total reducing capacity in ‘Xuehua’ pear ferment; thus, the ‘Xuehua’ pear ferment could be considered as an easily digestible food.

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Development of a novel tongue biofilm index using bacterial biofluorescence

Park,

Lee,

Kim

et al. 2024

Sci Rep

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Conventional methods for assessing tongue bacterial biofilms have low inter-examiner reliability due to visualization challenges. This study aimed to develop and assess a novel Tongue Biofilm Fluorescence Index (TBFI) for the accurate detection and objective evaluation of the quantitative and qualitative characteristics of tongue biofilms at the chairside. Data were collected from 81 elderly individuals (n = 162 images). Qraycam captured white-light and fluorescence images of the dorsal tongue, and two examiners assessed tongue coating (TC) using the TBFI. The TBFI was calculated based on biofilm intensity and coverage (0–2 scale). Inter-examiner agreement (Kappa) was compared with the Winkel’s Tongue Coating Index (WTCI) and the Oho Index. Validity was evaluated through correlations with hydrogen sulfide (H₂S) and methyl mercaptan (CH₃SH) levels. TBFI demonstrated the highest inter-examiner reliability (TBFI, κ = 0.752; WTCI, κ = 0.317; Oho Index, κ = 0.496), particularly for thickness rating (agreement rate: TBFI, 96.3%; WTCI, 76.5%; Oho Index, 79.6%). H₂S and CH₃SH concentrations showed significant positive correlations with all three indices, with the highest correlation observed between H₂S and TBFI (TBFI, r = 0.369; WTCI, r = 0.304; Oho Index, r = 0.308; p < 0.01). Furthermore, H₂S levels increased significantly with higher TBFI scores (p < 0.0001). TBFI shows enhanced reliability and validity, supporting its clinical potential.

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Reliability, Accuracy, and Use Frequency of Evaluation Methods for Amount of Tongue Coating

Cited by 6 publications

References 111 publications

Association between tongue coating thickness and ultraviolet fluorescence in patients with functional dyspepsia

Association between tongue coating thickness and ultraviolet fluorescence in patients with functional dyspepsia

Changes of Bioactive Components and Antioxidant Capacity of Pear Ferment in Simulated Gastrointestinal Digestion In Vitro

Development of a novel tongue biofilm index using bacterial biofluorescence

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