Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 1;28(2):e456-e461.
doi: 10.1097/RHU.0000000000001760.

Preliminary Screening Questionnaire for Sjögren's Syndrome in the Rheumatology Setting

Kimberley Yu  1 , Gui-Shuang Ying  2 , Frederick B Vivino  3 , John A Gonzales, Mina Massaro-Giordano  2 , Vatinee Y Bunya  2
Affiliations

Preliminary Screening Questionnaire for Sjögren's Syndrome in the Rheumatology Setting

Kimberley Yu et al. J Clin Rheumatol. .

Abstract

Objective: Sjögren's syndrome (SS) is frequently undetected or misdiagnosed as other rheumatologic diseases. We aimed to develop an SS screening questionnaire for the rheumatology practice.

Methods: We developed the Sjögren's Syndrome Screening Questionnaire (SSSQ) via secondary analysis of data from 974 participants referred by rheumatologists to the Sjögren's International Collaborative Clinical Alliance (SICCA) study. Participants answered 88 questions regarding symptoms, medical history, and demographics. They underwent ocular, dental, and serologic tests and were classified as SS or non-SS using the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria. We conducted univariate and multivariate logistic regression to identify questions most discriminative of SS, from which we derived an individual's likelihood of SS ("SSSQ score").

Results: Five questions were significantly discriminative of SS in the multivariate analysis (p < 0.05): (1) Can you eat a cracker without drinking a fluid/liquid? (no: odds ratio [OR], 1.39; 95% confidence interval [CI], 1.06-1.82]); (2) How would you describe your dental and oral health in general? (fair/poor: OR, 1.68; 95% CI, 1.04-2.75); (3) During the last week, have you experienced tearing? (none of the time: OR, 2.26; 95% CI, 1.23-4.34); (4) Are you able to produce tears? (no: OR, 1.62; 95% CI, 1.12-2.37); and (5) Do you currently smoke cigarettes? (no: OR, 2.83; 95% CI, 1.69-4.91). SSSQ score ≥7 (possible range, 0-11) distinguishes SS from non-SS patients with 64% sensitivity and 58% specificity (area under receiver operating characteristic curve, 0.65).

Conclusions: The SSSQ is a simple 5-item questionnaire designed to screen for SS in clinical practice, with a potential impact to reduce delays in diagnosis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
The fraction of patients with Sjögren’s syndrome (SS) increases as the Sjögren’s Syndrome Screening Questionnaire (SSSQ) score increases.
Figure 2.
Figure 2.
The Sjögren’s Syndrome Screening Questionnaire (SSSQ) score discriminates Sjögren’s syndrome (SS) vs. non-SS with an AUC of 0.65. An SSSQ score cut point of 7 maximizes Youden’s J index (sensitivity + specificity – 1), with sensitivity=0.643, specificity=0.584, and Youden’s J index=0.227.
See this image and copyright information in PMC

Comment in

References

    1. Fox RI. Sjögren’s syndrome. The Lancet. 2005;366(9482):321–31. - PubMed
    1. Delalande S, De Seze J, Fauchais A-L, et al. Neurologic manifestations in primary Sjögren syndrome: a study of 82 patients. Medicine. 2004;83(5):280–91. - PubMed
    1. Bartoloni E, Baldini C, Schillaci G, et al. Cardiovascular disease risk burden in primary Sjögren’s syndrome: results of a population-based multicentre cohort study. J Intern Med. 2015;278(2):185–92. - PubMed
    1. Baer A, Ambinder R. Lymphoproliferative disease in Sjögren’s syndrome. In: Vivino F, ed. Sjögren’s Syndrome: A Clinical Handbook. Amsterdam: Elsevier, Inc; 2020. p. 129–52.
    1. Heaton J. Sjögren’s syndrome and systemic lupus erythematosus. Br Med J. 1959;1(5120):466. - PMC - PubMed