{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:06:08Z","timestamp":1776211568636,"version":"3.50.1"},"reference-count":63,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T00:00:00Z","timestamp":1690761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["R21 DE027786-02"],"award-info":[{"award-number":["R21 DE027786-02"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["1R56DE029195-01"],"award-info":[{"award-number":["1R56DE029195-01"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Established classifications exist to confirm Sj\u00f6gren\u2019s Disease (SD) (previously referred as Sj\u00f6gren\u2019s Syndrome) and recruit patients for research. However, no established classification exists for diagnosis in clinical settings causing delayed diagnosis. SD patients experience a huge dental disease burden impairing their quality of life. This study established criteria to characterize Indiana University School of Dentistry (IUSD) patients\u2019 SD based on symptoms and signs in the electronic health record (EHR) data available through the state-wide Indiana health information exchange (IHIE). Association between SD diagnosis, and comorbidities including other autoimmune conditions, and documentation of SD diagnosis in electronic dental record (EDR) were also determined. The IUSD patients\u2019 EDR were linked with their EHR data in the IHIE and queried for SD diagnostic ICD9\/10 codes. The resulting cohorts\u2019 EHR clinical findings were characterized and classified using diagnostic criteria based on clinical experts\u2019 recommendations. Descriptive statistics were performed, and Chi-square tests determined the association between the different SD presentations and comorbidities including other autoimmune conditions. Eighty-three percent of IUSD patients had an EHR of which 377 patients had a SD diagnosis. They were characterized as positive (24%), uncertain (20%) and negative (56%) based on EHR clinical findings. Dry eyes and mouth were reported for 51% and positive Anti-Ro\/SSA antibodies and anti-nuclear antibody (ANA) for 17% of this study cohort. One comorbidity was present in 98% and other autoimmune condition\/s were present in 53% respectively. Significant differences were observed between the three SD clinical characteristics\/classifications and certain medical and autoimmune conditions (p&lt;0.05). Sixty-nine percent of patients\u2019 EDR did not mention SD, highlighting the huge gap in reporting SD during dental care. This study of SD patients diagnosed in community practices characterized three different SD clinical presentations, which can be used to generate SD study cohorts for longitudinal studies using EHR data. The results emphasize the heterogenous SD clinical presentations and the need for further research to diagnose SD early in community practice settings where most people seek care.<\/jats:p>","DOI":"10.1371\/journal.pone.0289335","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T17:27:59Z","timestamp":1690824479000},"page":"e0289335","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Characterizing clinical findings of Sj\u00f6gren\u2019s Disease patients in community practices using matched electronic dental-health record data"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8729-2277","authenticated-orcid":true,"given":"Grace Gomez","family":"Felix Gomez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven T.","family":"Hugenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Zunt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay S.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anushri Singh","family":"Rajapuri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren R.","family":"Lembcke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divya","family":"Rajendran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas C.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2544-8568","authenticated-orcid":true,"given":"Biju","family":"Cheriyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3549-2124","authenticated-orcid":true,"given":"LaKeisha J.","family":"Boyd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7798-7155","authenticated-orcid":true,"given":"George J.","family":"Eckert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun J.","family":"Grannis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mythily","family":"Srinivasan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenick T.","family":"Zero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7294-2318","authenticated-orcid":true,"given":"Thankam P.","family":"Thyvalikakath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,7,31]]},"reference":[{"issue":"6","key":"pone.0289335.ref001","first-page":"365","article-title":"Sj\u00f6gren\u2019s Syndrome: Oral Manifestations and Treatment, a Dental Perspective.","volume":"89","author":"DL Cartee","year":"2015","journal-title":"J Dent Hyg."},{"key":"pone.0289335.ref002","article-title":"Sjogrens Syndrome Foundation","journal-title":"Autoimmune disorders, Sjogrens and Women [Internet]."},{"issue":"1","key":"pone.0289335.ref003","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/art.23177","article-title":"Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. 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