Observational studyArthritis research & therapy2020
Unstimulated whole saliva flow for diagnosis of primary Sjögren's syndrome: time to revisit the threshold?
Observational study in Arthritis research & therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Salivary Biomarkers in Patients with Sjögren's Syndrome-A Systematic Review.International journal of molecular sciences · 2021Pooled it
- Comparison of gargling and swabbing methods for delivering pre-procedural povidone-iodine mouthrinse: a randomised crossover trial.BMC oral health · 2026Trial
- Salivary Dysfunction in Primary and Secondary Sjögren's Syndrome: Functional Assessment and the Exploratory Role of Salivary Microcrystallization.Dentistry journal · 2026Article
- Age-specific reference values for unstimulated whole saliva flow rate in primary Sjögren's syndrome: a cross-sectional study.BMC oral health · 2026Article
- From Sjögren syndrome to Sjögren disease: rethinking classification and diagnostic complexity.The Korean journal of internal medicine · 2026Review
- Dry Mouth by Report or by Measure? Comparison of Fox and Xerostomia Inventory Scores with Sialometry.BMC oral health · 2026Article
- Minor salivary flow as a diagnostic tool for screening hyposalivation in Medication-Induced Xerostomia.BMC oral health · 2026Article
- Oral Manifestations of Sjögren's Syndrome: Recognition, Management, and Interdisciplinary Care.Medicina (Kaunas, Lithuania) · 2025Review
- Impact of Dry Mouth and Factors Associated with Sarcopenia on Oral Health-Related Quality of Life in Peritoneal Dialysis Patients.European journal of dentistry · 2025Article
- Salivaomics: New Frontiers in Studying the Relationship Between Periodontal Disease and Alzheimer's Disease.Metabolites · 2025Review
- Real-world diagnostic value of integrating oral and ocular dryness testing in suspected Sjögren's disease.Frontiers in medicine · 2025Article
- Can unstimulated whole salivary flow objectively classify salivary gland secretory function in Sjögren's syndrome?Clinical rheumatology · 2024Article
- Untargeted stimulated and unstimulated salivary metabolomics and saliva flow rate in children.Clinical oral investigations · 2024Article
- Targeted saliva metabolomics in Sjögren's syndrome.Clinics (Sao Paulo, Brazil) · 2024Article
- Metabolic Profile of Whole Unstimulated Saliva in Patients with Sjögren's Syndrome.Metabolites · 2023Article
- An immuno-lipidomic signature revealed by metabolomic and machine-learning approaches in labial salivary gland to diagnose primary Sjögren's syndrome.Frontiers in immunology · 2023Article
- Article
- Impact of age on the diagnostic performance of unstimulated salivary flow rates and salivary gland ultrasound for primary Sjögren's syndrome.Frontiers in medicine · 2022Article
- Is it possible to not perform salivary gland biopsy in targeted patients according to unstimulated salivary flow results in patients with suspected Sjögren's syndrome?Rheumatology international · 2021Observational
- Stimulated whole salivary flow rate: The most appropriate technique for assessing salivary flow in Sjögren syndrome.Medicina oral, patologia oral y cirugia bucal · 2021Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnstimulated whole saliva (UWS) flow rate is one of the ACR/EULAR 2016 criteria for primary Sjögren's syndrome (pSS). With a single threshold of ≤ 0.1 mL/min, UWS flow does not take into account the age- and sex-related physiological variations. Furthermore, it has a low sensitivity for the diagnosis of pSS (about 50%), contrary to the screening test for xerophthalmia, Schirmer's test (sensitivity of about 70%). We aimed to identify UWS thresholds allowing better performances for a screening test for pSS comparable to Schirmer's test, and considering age- and sex-related variations.
methodsA prospective cohort of 185 patients with oral and/or ocular dryness was classified into 3 groups: men, women < 50 (< 50 years old), and women ≥ 50 (≥ 50 years old). The diagnostic performances of UWS flow rate in these groups were compared in terms of sensitivity, specificity, positive and negative predictive values, and ROC curves. The identification of thresholds that optimize diagnostic performances was carried out using Youden's index.
resultsThe diagnostic performances of UWS flow rate varied according to age and sex. UWS had poor diagnostic performances whatever the threshold in the women ≥ 50 group. The threshold of 0.2 mL/min had a sensitivity of ≥ 70% and a specificity of ≥ 50% in both men and women < 50 groups. In the whole population and compared to the current cutoff, a threshold of 0.2 mL/min increased sensitivity (+ 19.8%) and positive (+ 2.3%) and negative (+ 7.0%) predictive values, with a better specificity (65.2%) than Schirmer's test.
conclusionFor objective assessment of xerostomia, raising the threshold of the UWS flow rate to 0.2 mL/min would optimize its screening performances for pSS.
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