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Evidence-Based Complementary and Alternative Medicine
Volume 2012, Article ID 505063, 9 pages
Research Article

The Study on the Agreement between Automatic Tongue Diagnosis System and Traditional Chinese Medicine Practitioners

1Department of Traditional Chinese Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
2Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua 500, Taiwan
3Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung 402, Taiwan
4Department of Health Services Administration, China Medical University, Taichung 402, Taiwan
5Department of Computer Science & Engineering, National Sun Yat-sen University, Kaohsiung 424, Taiwan

Received 5 April 2012; Accepted 25 June 2012

Academic Editor: Ching Liang Hsieh

Copyright © 2012 Lun-chien Lo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Tongue diagnosis is an important practice in traditional Chinese medicine (TCM) for diagnosing diseases before determining proper means of treatments. Traditionally, it depends solely on personal knowledge and experience of the practitioner, thereby being criticized as lacking of objectivity. Currently, no research regarding intra- and inter-agreements of automatic tongue diagnosis system (ATDS) and TCM doctors has been conducted. In this study, the ATDS is developed to extract a variety of tongue features and provide practitioners with objective information to assist diagnoses. To evaluate the ATDS clinical stability, 2 sets of tongue images taken 1 hour apart from 20 patients with possible variations in lighting and extruding tongue, are employed to investigate intra-agreement of the ATDS, intra-agreement of the TCM doctors, and the inter-agreement between the ATDS and TCM doctors. The ATDS is shown to be more consistent with significantly higher intra-agreement than the TCM doctors (kappa value: versus ) with (Student’s t-test). Inter-agreements between the ATDS and TCM doctors, as well as among the TCM doctors are both moderate. The high agreement of the ATDS can provide objective and reliable tongue features to facilitate doctor in making effective observation and diagnosis of specific diseases.