Tongue diagnosis models in Persian medicine: A Delphi study

Introduction: In Persian Medicine (PM), diagnosis of physiological characteristics and disease symptoms is ach-ieved by clinical indices. This study aimed to present selected tongue images as the first educational model in this area of PM.Methods: In this Delphi study, tongue diagnostic indices were extracted from reliable PM sources. Twenty PM experts were interviewed regarding their clinical experience on the subject. Tongue photographs were taken, standardized and printed to the extent of data saturation. In face-to-face interviews with experts, they selected some images and described their characteristics. Images selected by at least 25% of the interviewees were allocated to reach a consensus on gathered opinions. Subsequently, images with highest agreement among ex-perts regarding a specific diagnostic index were presented as an educational model.Results: Tongue color, thickness and color of coating, size, shape, moisture, dryness and fissures are most commonly used by PM physicians. Out of 221 standardized images in the first stage, 54 and then 13 images were selected as typical educational models. Conclusion: As the initial steps of standardization of PM diagnostic indices, selected tongue images can be used for educational and research purposes in PM diagnostics. However, future studies are need to increase the accuracy of diagnostic models.