Sjögren's Classification Criteria: Reading the Points in Your Records

Updated 10 October 2026

Reading about Sjögren's soon leads to a scoring system with points, cut-offs and abbreviations that sound like a verdict. The system exists, but its purpose and its reach are narrower than they look, and the useful part for most people is knowing which tests lie behind it.

This guide sets out what the 2016 ACR-EULAR criteria, the Sjögren's Foundation, Cleveland Clinic, MedlinePlus and a Dutch cohort report say about the points and the tests, then offers a table of the five scored items, a record sheet, a word list, four steps and a one-page summary for visits.

What the ACR-EULAR points, the Foundation pages, Cleveland Clinic and MedlinePlus say about the five scored items and the tests behind them

The 2016 ACR-EULAR paper describes the structure in its results: "The final classification criteria are based on the weighted sum of 5 items: anti-SSA(Ro) antibody positivity and focal lymphocytic sialadenitis with a focus score ≥ 1 foci/mm 2, each scoring 3; an abnormal ocular staining score ≥ 5 (or van Bijsterveld score ≥ 4), a Schirmer test ≤ 5 mm/5 min, and an unstimulated salivary flow rate ≤ 0.1 mL/min, each scoring 1." It then states the cut-off: "Individuals (with signs/symptoms suggestive of SS) who have a total score ≥ 4 for the items above, meet the criteria for pSS." The authors conclude that the criteria are "well-suited as entry criteria for clinical trials."

The Foundation's diagnosis page spells out what that means for a clinic visit: "These published classification criteria are designed for use in clinical trials and not for diagnosing patients in a clinic for general management and treatment." Two other pages describe the everyday route. MedlinePlus says: "There is no single test for Sjogren's syndrome." Cleveland Clinic says: "Diagnosing Sjögren's syndrome is usually part of a differential diagnosis."

The Foundation's signs and symptoms page draws a line between what a person feels and what a clinician can measure: "Signs of Sjögren's disease can be measured, observed, or detected by a doctor or another healthcare professional and indicate that a person has Sjögren's." The tests behind the points are examples of such signs. Once a diagnosis is made, a Dutch cohort of 265 patients reports a disease activity score that "was assessed at least yearly, up to 5 years," which shows that results continue to be recorded after diagnosis.

None of these pages tells a reader to add up their own points, and the criteria paper says they were built to classify people for research. A person can bring the dated test results themselves, and a clinician decides what they mean.

Each report date and result line can be typed into My Labs in Sjögren's Journey (by Health Journey Labs), so test findings sit in the same history as the days of dryness around them.

A table of the five scored items: what each one measures, its points and how it appears in a record

The table lays the five items from the 2016 criteria beside a plain description of the test and the kind of line a report or letter might show. The points come from the paper and are listed to explain the structure, and your clinician reads the findings.

Table of the five scored items, by Sjögren’s Journey

The table shows why a person with a negative blood result may still have other items on the page, and why the same total can come from different combinations. Whether the points apply to you is for your clinicians to say. The guide to filing eye tests with Sjögren's symptom weeks goes deeper on the eye side.

One short entry per day on the eyes and mouth can be made in the Daily check-in of Sjögren's Journey, and a day that stood out can be flagged in the Flare Tracker with a few words.

A test-and-result record for the clinician visit: what was done, when and what the report said, with sample rows

When a clinician asks which tests have been done, answers from memory tend to blur dates and names. A record with one row per test lets you answer in a minute. All five sample rows are fictional and exist only to show the layout; no source supplied them.

Test results table, by Sjögren’s Journey

Fill in whichever columns fit, and a gap is perfectly fine. The report column is for what the paper says, copied the way it is written and without translating it. The told column holds what a clinician said aloud, with the person's name if you caught it.

Looking down the date column across a few months shows which parts of the work-up are finished and which are waiting. The guide to tracking Sjögren's labs with dryness and fatigue weeks pairs results with how the weeks felt.

Questions about a particular report can wait in My Care Team within Sjögren's Journey, so they sit with the clinician who ordered the test.

Words for tests, reports and results: what was measured, what it said and what was explained

Reports use abbreviations, and clinicians use another set aloud. A list of plain words, with the report's own wording copied beside them, keeps the record readable on the day you need it.

Words for tests and reports

Sjögren’s Journey offers words for tests and reports.

• Test words: blood test, tear test, eye surface test, saliva test, lip biopsy, eye exam, dental check.
• Abbreviation words: SSA or Ro, SSB or La, Schirmer, OSS, focus score, ESSDAI.
• Result words: positive, negative, borderline, abnormal, within range, pending, repeat requested.
• Status words: booked, done, report awaited, letter received, explained, not yet explained.
• Source words: eye clinic, dental clinic, rheumatology, oral medicine, general practice.

Pick whichever words match the paper in your hand, then date the entry. Copying the report's wording matters more than decoding it, because a clinician can read it and cannot read a paraphrase of a paraphrase. The abbreviation words follow the tests that appear in the criteria paper and on the Foundation page, and the clinic may use others. Fainting, sudden vision changes or any sudden severe symptom is a reason to contact a clinician or your local emergency number first, with the record put aside.

Report wording can be saved in the Daily Journal of Sjögren's Journey exactly as it was written, with the date it reached you.

Four steps and questions for the clinician visit that goes through your test reports

Report review often gets squeezed into the last few minutes of a visit, so a few steps beforehand help the record carry its weight. The steps only arrange what you already hold.

Steps for a visit about test reports

Sjögren’s Journey lists each test with its date.

1. List each test done so far, with its date, and leave a cell blank when you are unsure.
2. Add what the paper says for each one, in the report's own words.
3. Mark the tests still waiting, booked or repeated, with the date each was requested.
4. Pick two or three questions, with the most pressing one listed first.

From Sjögren's Journey, we recommend finishing the list the evening before the visit (Sjögren's Journey checklist), so the newest results are on the page.

Questions can stay descriptive, such as which results are still outstanding, who explains them and when the work-up is reviewed again. The sources leave these for the clinic to answer for your case.

When a result is explained in the room, jot the explanation against its row, so the following appointment can pick up from there. The guide to normal labs with Sjögren's dryness covers the case where results come back in range.

Your finished list can become a one-page export through the Doctor Report in Sjögren's Journey before the report review begins.

A summary page for the clinician: tests done, dates and what each report said

A single page lets the clinician see the state of the work-up before asking anything. It holds the list of tests, and the reports themselves stay in your folder.

Summary page list, by Sjögren’s Journey

• The dates the record covers, in one line.
• Each test done, with its date and who did it.
• What each report said, in its own wording.
• Which results were explained and which are waiting.
• Your typical dryness and any other symptoms, in a line or two.
• Two or three questions for this visit.

Offer the sheet at the start and suggest reading it together, row by row. Anything the clinician asks you to add goes in with its date, and the next summary then carries it along. Keep a copy for yourself.

The page records dates, reports and replies. Whether the criteria apply to you, and what your results mean, are for your clinicians to decide, and no page, source or app can decide it. Severe pain or any sudden severe symptom is a reason to call your local emergency number before anything else.

A one-page export from the Doctor Report in Sjögren's Journey can open the conversation with the test list already in order.

How Sjögren's Journey can help

A folder is enough to begin. If you want test dates, reports and symptoms in one dated history, the best Sjögren's apps guide compares the options.

Sjögren's Journey is a personal sjogrens tracker from Health Journey Labs on the App Store and Google Play. Tests, dates and report wording on one page give a clinician the state of the work-up at a glance. Interpreting the points belongs to your clinicians, and the record hands them the dates, the reports and the replies as they arrived. Below is what you can use and how each part helps.

• Daily check-in — Logs physical symptoms, emotional state, nutrition, sleep, exercise, meds, external factors; app-specific items: eye dryness, mouth dryness, fatigue; read together with the rest of the logged history.
• Flare Tracker — Logs flag a day clearly worse than the usual hard week, onset, intensity, short note; app-specific items: grit, cotton mouth, pain, a crash; read together with history across weeks (one-off spike vs repeating pattern).
• Daily Journal — Logs free-text notes, voice entry; app-specific items: what the day limited, AC/screens/wind context, partner talks, visit debriefs, leftover guilt after you canceled; read together with scores and other logged history (adds context).
• Learn — Logs short education topics, prompts; app-specific items: dryness, fatigue, pacing, visit prep, dryness on days that look fine; read together with your own logged weeks.
• AI companions — Logs Clara (general chat), specialist companions; app-specific items: knowledge, fitness, nutrition, relationships; read together with your logged history (companions already see it); used for: visit wording; a calm partner script; a soft rain-check line; a listening ear after a hard dryness day.
• Weekly Goals — Logs one small aim, whether it held; read together with real check-ins.
• My Meds — Logs medicine names, timing, dose; app-specific items: artificial tears, gels, saliva substitutes, other options you actually use; read together with dryness weeks, sleep, energy, the rest of the tracked history.
• My Labs — Logs result dates; app-specific items: antibody panels, inflammatory markers, imaging, other tests; read together with dryness, fatigue, function.
• My Care Team — Logs clinicians, short visit notes; app-specific items: tends to ask mainly about tears rather than function; read together with logged history; used for: visit prep (what to ask and bring); notes during the visit; review afterward.
• Doctor Report — Logs one-page summary exported from logged history; app-specific items: dates, dryness, fatigue, how you functioned; read together with the history already logged; visit type: clinic.
• My Assessments — Logs structured check-ins beyond daily scores, onboarding life and social context; read together with ongoing history.
• Food Tracker — Logs meal or drink lines, caffeine, alcohol; read together with dryness.
• Period Tracker — Logs start and stop dates, flow, how heavy or light bleeding felt; read together with flares, dryness, sleep, energy, everything else logged.
• Weight Tracker — Logs scale or body notes; read together with energy, sleep, dryness.

Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.

Sources

• Arthritis & Rheumatology: 2016 ACR-EULAR classification criteria for primary Sjögren's syndrome, a consensus and data-driven methodology involving three international patient cohorts
• Sjögren's Foundation: diagnosis
• Cleveland Clinic: Sjögren's syndrome
• MedlinePlus, National Library of Medicine: Sjögren's syndrome
• Sjögren's Foundation: Sjögren's disease signs and symptoms
• RMD Open: disease activity over up to five years in a Dutch Sjögren's cohort

FAQ

The answers below draw on the sources cited in this guide, and the app they mention is Sjögren's Journey (by Health Journey Labs).