Can We Determine Sasang Constitutional Body Type Merely by Facial Inspection?

Area of Science:

• Integrative Medicine
• Anthropometry
• Traditional Korean Medicine

Background:

• Sasang constitutional medicine (SCM) is a traditional Korean medical system that categorizes individuals into distinct body types (Sasang constitution - SC).
• Diagnosis of SC types traditionally relies on subjective assessments, including facial feature analysis by experts.
• Potential for diagnostic errors due to inter-observer variability in subjective facial assessments necessitates objective evaluation methods.

Purpose of the Study:

• To evaluate the inter-observer agreement among SCM experts in diagnosing SC types via facial examination.
• To investigate statistical differences in facial structural characteristics across different SC types.
• To develop an objective, photogrammetric method for SC type diagnosis to enhance accuracy and prevent misdiagnosis.

Main Methods:

• A double-blinded, cross-sectional study involving 174 participants and 10 SCM experts.
• Experiment 1: SCM experts diagnosed SC types from standardized facial photographs (anthroscopic examination).
• Experiment 2: Photogrammetric analysis was used to identify objective facial structural characteristics correlating with SC types, employing a multinomial logistic model.

Main Results:

• Low inter-observer concordance rate of 2.9% for anthroscopic facial examination in diagnosing SC types.
• Photogrammetric analysis achieved a predicted probability of 52.8-57.6% for determining SC type (p < 0.05).
• Prototype composite faces were generated for each SC type based on expert consensus.

Conclusions:

• Anthroscopic examination alone is insufficient for precise SC type diagnosis.
• Objective, scientific diagnostic methods are crucial for validating SCM as an alternative medicine and for its globalization.
• Photogrammetric facial analysis shows promise as an objective tool for improving SC diagnosis accuracy.