Application value of the NoSAS score for screening sleep-disordered breathing

Peng, Min; Chen, Riken; Cheng, Junfen; Li, Jieying; Liu, Wang; Hong, Cheng

doi:10.21037/jtd.2018.07.46

Cited by 27 publications

(21 citation statements)

References 25 publications

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“…Our study, performed in a population from a sleep clinic, yielded an obvious lower AUC of the NoSAS score than a previous study [18] which included Caucasians and was also carried out in a sleep clinic (0.715 vs. 0.770 for all SDB; 0.697 vs. 0.746 for moderate-to-severe SDB). Similar results were also observed that AUCs of the NoSAS score in the Asian populations [10][11][12] were lower than in the Caucasian populations [9,16,17]. ese may be partially explained by the difference in the pathogenesis of SDB between Asians and Caucasians.…”

Section: Discussionsupporting

confidence: 76%

“…e AUCs of the NoSAS score reached as high as 0.81 in the EPISONO cohort and 0.748 in the Asian population while the AUCs of STOP-Bang were almost around 0.7. When applied in hospital-based populations [11,12], the NoSAS score had equivalent or higher performance than the other tools including STOP-Bang questionnaire, ESS, and Berlin scores. Additionally, the NoSAS score was shown to be effective in predicting SDB in patients with depressive majors [16] or with insomnia [17].…”

Section: Discussionmentioning

confidence: 89%

“…At a threshold of 8 points, it performed significantly better than STOP-Bang and Berlin questionnaires with a larger area under the ROC curve (AUC), indicating that NoSAS score was an efficient tool to discriminate individuals at high risk of SDB. Some studies performed comparisons between the NoSAS score and other questionnaires in different populations and found similar or better performances of NoSAS score to STOP-Bang, Berlin, or ESS questionnaires [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic

Rong

Wang

et al. 2020

Canadian Respiratory Journal

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Background. There is a growing number of patients with sleep-disordered breathing (SDB) referred to sleep clinics. Therefore, a simple but useful screening tool is urgent. The NoSAS score, containing only five items, has been developed and validated in population-based studies. Aim. To evaluate the performance of the NoSAS score for the screening of SDB patients from a sleep clinic in China, and to compare the predictive value of the NoSAS score with the STOP-Bang questionnaire. Methods. We enrolled consecutive patients from a sleep clinic who had undergone apnea-hypopnea index (AHI) testing by type III portable monitor device at the hospital and completed the STOP-Bang questionnaire. The NoSAS score was assessed by reviewing medical records. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of both screening tools were calculated at different AHI cutoffs to compare the performance of SDB screening. Results. Of the 596 eligible patients (397 males and 199 female), 514 were diagnosed with SDB. When predicting overall (AHI ≥ 5), moderate-to-severe (AHI ≥ 15), and severe (AHI ≥ 30) SDB, the sensitivity and specificity of the NoSAS score were 71.2, 80.4, and 83.1% and 62.4, 49.3, and 40.7%, respectively. At all AHI cutoffs, the AUC ranged from 0.688 to 0.715 for the NoSAS score and from 0.663 to 0.693 for the STOP-Bang questionnaire. The NoSAS score had the largest AUC (0.715, 95% CI: 0.655–0.775) of diagnosing SDB at AHI cutoff of ≥5 events/h. NoSAS performed better in discriminating moderate-to-severe SDB than STOP-Bang with a marginally significantly higher AUC (0.697 vs. 0.663, P=0.046). Conclusion. The NoSAS score had good performance on the discrimination of SDB patients in sleep clinic and can be utilized as an effective screening tool in clinical practice.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic

Rong

Wang

et al. 2020

Canadian Respiratory Journal

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“…The fact that the NoSAS score consist of objective parameters may also have played a role in having a higher specificity than the other questionnaires in our population. Additionally, containing any subjective parameter except for snoring makes the NoSAS score more convenient for clinicians to use [20].…”

Section: Discussionmentioning

confidence: 99%

Validation of the NoSAS score for screening sleep-disordered breathing: A sleep clinic- based study in Turkey

Arslan¹,

Uçar²,

Batum³

et al. 2021

Turk J Med Sci

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Background/aim: NoSAS score is a new tool for identification of high-risk patients for sleep disordered breathing (SDB). The aim of this study was to validate the NoSAS score in sleep clinical population in Turkey and, compare its performance with Epworth Sleepiness Scale (ESS), STOP-Bang and Berlin questionnaires for high-risk SDB. Materials and Methods: This was a retrospective study. Patients who had full-night PSG examination between 01.03.2017 and 01.01.2018 at the sleep center of our hospital were included in the study. Demographic characteristics, anthropometrics measurements, ESS, STOP-Bang and Berlin scores were collected from the existing data of the patients. The NoSAS score was subsequently calculated based on available data. Predictive parameters for each screening questionnaires were calculated to compare the discriminative power of those for high-risk SDB. Results: A total of 450 patients were included in the study. The sensitivity, specificity, PPV and NPV of the NoSAS score were 81%, 51.2%, 88.2%, 37.5% for AHI≥5 event/h and 84.5%, 38.2%, 66%, 63.4% for AHI≥15 event/h respectively. AUC for the NoSAS score, STOP-Bang questionnaire, Berlin questionnaire and ESS were 0.740, 0.737, 0.626, 0.571 for AHI≥5 events/h and 0.715, 0.704, 0.574, 0.621 for AHI≥30 events/h. NoSAS score had a false negative rate of 2.9% for severe SDB. Conclusion: NoSAS score had a good degree of differentiation for SDB and can be used as an easily applicable, subjective and effective screening tool in sleep clinical population in Turkey. Not only in moderate to severe SDB, but also in mild SDB NoSAS score performed better than other three screening tools.

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“…17 Afterwards, this score was also validated in different settings, reporting adequate performance as screening model for OSA: in a multiethnic Asian cohort, in a hospital-based sample, in depressive subjects, and in a sleep clinic. [18][19][20][21][22] The No-Apnea 23 tool is a newly developed and validated screening instrument that includes only two objective parameters: neck circumference (NC) and age, with a total score ranging from 0 to 9 (cutoff point ≥3 classifies patients at high risk for OSA). In derivation and validation cohorts, No-Apnea showed adequate performance in OSA screening, with a discriminatory ability that was similar and indistinguishable from the performance of either STOP-Bang or NoSAS.…”

Section: Introductionmentioning

confidence: 99%

<p>Obstructive Sleep Apnea Screening with a 4-Item Instrument, Named GOAL Questionnaire: Development, Validation and Comparative Study with No-Apnea, STOP-Bang, and NoSAS</p>

Duarte¹,

Magalhães-da-Silveira²,

Sá³

et al. 2020

NSS

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Background: Obstructive sleep apnea (OSA) is a very prevalent disorder. Here, we aimed to develop and validate a practical questionnaire with yes-or-no answers, and to compare its performance with other well-validated instruments: No-Apnea, STOP-Bang, and NoSAS. Methods: A cross-sectional study containing consecutively selected sleep-lab subjects underwent full polysomnography. A 4-item model, named GOAL questionnaire (gender, obesity, age, and loud snoring), was developed and subsequently validated, with item-scoring of 0-4 points (≥2 points indicating high risk for OSA). Discrimination was assessed by area under the curve (AUC), while predictive parameters were calculated using contingency tables. OSA severity was classified based on conventionally accepted apnea/hypopnea index thresholds: ≥5.0/h (OSA ≥5), ≥15.0/h (OSA ≥15), and ≥30.0/h (OSA ≥30). Results: Overall, 7377 adults were grouped into two large and independent cohorts: derivation (n = 3771) and validation (n = 3606). In the derivation cohort, screening of OSA ≥5 , OSA ≥15 , and OSA ≥30 revealed that GOAL questionnaire achieved sensitivity ranging from 83.3% to 94.0% and specificity ranging from 62.4% to 38.5%. In the validation cohort, screening of OSA ≥5 , OSA ≥15 , and OSA ≥30 , corroborated validation steps with sensitivity ranging from 83.7% to 94.2% and specificity from 63.4% to 37.7%. In both cohorts, discriminatory ability of GOAL questionnaire for screening of OSA ≥5 , OSA ≥15 , and OSA ≥30 was similar to No-Apnea, STOP-Bang or NoSAS. Conclusion: All four instruments had similar performance, leading to a possible greater practical implementation of the GOAL questionnaire, a simple instrument with only four parameters easily obtained during clinical evaluation.

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Application value of the NoSAS score for screening sleep-disordered breathing

Abstract: The NoSAS score and the Berlin questionnaire both exhibited good predictive value for SDB patients. NoSAS is a more suitable questionnaire to use in clinic for the conveniences but the similar performance with another questionnaire.

Cited by 27 publications

References 25 publications

Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic

Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic

Validation of the NoSAS score for screening sleep-disordered breathing: A sleep clinic- based study in Turkey

<p>Obstructive Sleep Apnea Screening with a 4-Item Instrument, Named GOAL Questionnaire: Development, Validation and Comparative Study with No-Apnea, STOP-Bang, and NoSAS</p>

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