| ObjectiveTo evaluate the value of Tongue analysis system in diagnosing the features of tongue, exploring the sensitivity and specificity of tongue color in RGB space and tongue size.MethodFrom Jun.2014 to Oct.2014,150 outpatients with insomnia treated in the department of Psychology and Sleep were collected in Guangdong Provincial Hospital of Chinese medicine, as a representative of the group of diseases. And the healthy group was collected from medical center in the hospital.The tongue image was collected by the automated tongue image acquisition and analysis system (patent number:200610150872.1), and the images was observed in two parts. One was by experts to be gold standard, and the other was by the automated tongue image analysis system, including the tongue color, tongue size and tooth-printed tongue.The database was setted up by EpiData 3.1, then import to SPSS. Statistics were performed using SPSS 18.0 software:descriptive statistical method used to analyze the distribution of general data, person chi-square test or correction chi-square test used to analyze contingency tables, rank-sum test used to analyze the quantitative values, the value of tongue analysis system in predicting features of tongue was analyzed by receiver operating characteristic (ROC) curves. The statistical charts were drawn by SPSS18.0 and Excel 2007.ResultsFrist, general features of tongueThe main features of tongue is pink, normal size and not tooth-printed. Tongue color and size is not related with age. Tooth-printed tongue is common in youth and middle-aged people, rare in old people. Tongue color and size is related with gender, but tooth-printed tongue not.Second, RGB values of pale tongue and pink tongueIn this study, there were 54 cases of pale tongue,233 cases of pink tongue, and there were differences between them on the tip and sides of the tongue, G value and B value was different while R value not, in particular, pale tongue: G value was 113.35+16.74, while for pink tongue was 104.46±14.51. B value was 113.33 ± 15.96, while for pink tongue is 104.85+13.25. Due to the limited sample, the quantitative value for different tongue color was still a preliminary study, and should be expanded for discussion.Third, the value of the system in diagnosing the features of tongueThe value of GO and B4 can both distinguish different tongue color, the diagnostic point of GO to tongue color is 114.22, and B4 is 110.35. So when value of G is greater than 114.22, the tongue color is pale. While smaller than 114.22 is pink. The sensitivity is 0.50, specificity is 0.76, and the accuracy is 0.71. The positive likelihood ratio is 2.17, and the negative likelihood ratio is 0.66. Similarly, when value of B is greater than 110.35, the tongue color is pale. While smaller than 110.35 is pink. The sensitivity is 0.56, specificity is 0.73, and the accuracy is 0.71. The positive likelihood ratio is 2.07, and the negative likelihood ratio is 0.60.Tongue width is related with tongue size, so it can distinguish small and normal tongue. As a diagnosis standard, the area under ROC curve is 0.825, and the diagnostic point of G to tongue size is 260.5. The sensitivity is 0.78.specificity is 0.74, and the accuracy is 0.78.The positive predictive value is 0.32 and negative predictive value is 0.96. The positive likelihood ratio is 3, and the negative likelihood ratio is 0.30.The tongue analysis system can distinguish tooth-printed tongue, taking consistency check With the gold standard, the kappa is 0.494, so the result of system is moderate consistent with gold standard. The sensitivity is 0.90.specificity is 0.60, and the accuracy is 0.84.The positive predictive value is 0.90 and negative predictive value is 0.59. The positive likelihood ratio is 2.25, and the negative likelihood ratio is 0.17. Conclus i on:Both value of GO and B4 can distinguish different tongue color, and the diagnostic point of G0 to tongue color is 114.22, B4 is 110.35. So when value of G is greater than 114.22, the tongue color is pale. While smaller than 114.22 is pink. The sensitivity is 0.50, specificity is 0.76 and the accuracy is 0.71. when vale of B is g greater than 110.35, the tongue color is pale. While smaller than 110.35 is pink. The sensitivity is 0.56, specificity is 0.73 and the accuracy is 0.71.Tongue width is related with tongue size, so it can distinguish small and normal tongue. As a diagnosis standard, the area under ROC curve is 0.825, and the diagnostic point of G to tongue size is 260.5.The tongue analysis system can distinguish tooth-printed tongue, taking consistency check with the gold standard, the kappa is 0.494, so the result of system is Moderate consistent with gold standard. |
PDF Full Text Request