Comparison of clinical scores in their ability to detect hypoxemic severe OSA patients

Deflandre, Eric; Piette, Nicolas; Bonhomme, Vincent; Degey, Stéphanie; Cambron, Laurent; Poirrier, Robert; Brichant, Jean-François; Joris, Jean

doi:10.1371/journal.pone.0196270

Cited by 10 publications

(6 citation statements)

References 37 publications

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“…The Youden index, commonly used to determine the optimal cutoff score where equal weight is given to SE and SP (defined as SEþSPe1, was also calculated). [37][38][39][40] For MAPI probability, cutoff scores of 0.1-0.9 in increments of 0.1 were summarized along with the optimal cutoff score. For the Berlin, participants were either low risk (0 or 1 category positive) or high risk (!2 categories positive), so there is only 1 possible cutoff score.…”

Section: Statistical Approachmentioning

confidence: 99%

Comparative Effectiveness of Sleep Apnea Screening Instruments During Inpatient Rehabilitation Following Moderate to Severe TBI

Nakase‐Richardson

Schwartz

Drasher-Phillips

et al. 2020

Archives of Physical Medicine and Rehabilitation

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To determine the diagnostic sensitivity and specificity and comparative effectiveness of traditional sleep apnea screening tools in traumatic brain injury (TBI) neurorehabilitation admissions. Design: Prospective diagnostic comparative effectiveness trial of sleep apnea screening tools relative to the criterion standard, attended level 1 polysomnography including encephalography. Setting: Six TBI Model System Inpatient Rehabilitation Centers. Participants: Between May 2017 and February 2019, 449 of 896 screened were eligible for the trial with 345 consented (77% consented). Additional screening left 263 eligible for and completing polysomnography with final analyses completed on 248. Intervention: Not applicable. Main Outcome Measures: Area under the curve (AUC) of screening tools relative to total apnea hypopnea index!15 (AHI, moderate to severe apnea) measured at a median of 47 days post-TBI (interquartile range, 29-47). Results: The Berlin high-risk score (receiving operating curve [ROC] AUCZ0.634) was inferior to the Multivariable Apnea Prediction Index (MAPI) (ROC AUCZ0.780) (PZ.0211; CI, 0.018-0.223) and Snoring, Tired, Observed, Blood Pressure, Body Mass Index, Age, Neck Circumference, and Gender (STOPBANG) score (ROC AUCZ0.785) (PZ.001; CI, 0.063-0.230), both of which had comparable AUC (PZ.7245; CI, À0.047 to 0.068). Findings were similar for AHI!30 (severe apnea); however, no differences across scales was observed at

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Section: Statistical Approachmentioning

confidence: 99%

Comparative Effectiveness of Sleep Apnea Screening Instruments During Inpatient Rehabilitation Following Moderate to Severe TBI

Nakase‐Richardson

Schwartz

Drasher-Phillips

et al. 2020

Archives of Physical Medicine and Rehabilitation

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“…By comparison with previous data, the present results emphasize that the ability of the P-SAP score and of the DES-OSA score to predict severe OSA patients are reproducible. 13,15 However, the reproducibility of these 2 scores on a same patient was never tested before this study.…”

Section: Discussionmentioning

confidence: 99%

Influence of Different Measurements on the Ability of P-SAP and DES-OSA Scores to Detect Severe Obstructive Sleep Apnea

Deflandre

Cester

Degey³

2021

Anesthesia &Amp; Analgesia

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BACKGROUND: Severe obstructive sleep apnea (sOSA) represents a risk factor of postoperative complications. Perioperative sleep apnea prediction (P-SAP) and DES-obstructive sleep apnea (DES-OSA) (DES being the acronym for 2 of the participating investigators and OSA for obstructive sleep apnea) scores were validated in the detection of such patients. They include the measurement of neck circumference (NC) and distance between thyroid and chin (DTC). The aim of this study was to evaluate the influence of the measurement method of NC and DTC on the ability of the 2 scores to detect sOSA. METHODS: A total of 371 preoperative patients were enrolled. For each of them, 6 combinations of P-SAP and DES-OSA scores were evaluated. We compared the results of the 6 combinations with the data extracted from the polysomnography (PSG) if available. The ability of the score to detect sOSA patients was evaluated using sensitivity (Se), specificity (Sp), Youden index (YI), area under receiver operating characteristic curve (AUROC), the Probit model, and the Kappa coefficient of Cohen. A P < .05 was considered as significant, a Bonferroni correction was applied if needed. RESULTS: Three hundred and seventy-one patients had a PSG. The Se and the Sp of the DES-OSA score, and the Sp of the P-SAP score, in their ability to detect severe OSA patients, were influenced by the measurement method of the DTC and of the NC. Nevertheless, the AUROC, the Youden index, the Probit model, and the Kappa coefficient of Cohen are not influenced by the variability of measurement. CONCLUSIONS: This study highlights that the measurement method of NC and DTC can influence the results of the 2 scores. We conclude that a strict protocol for the measurement of NC and DTC should be applied (DTC measurement should be performed on a patient with a head in neutral position and the NC measurement should be performed at the cricoid level).

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“…Some symptom indicators in these screening tools are subjective and the measure of anthropometric indicators requires relative professionalism skill, leading to unsatisfied feasibility and prediction performance. 16 , 17 The Epworth Sleepiness Scale (ESS) was originally designed to assess the risk of daytime sleepiness. Although the use of ESS is recommended, the predictive efficacy is low due to the lack of other relevant clinical indicators.…”

Section: Introductionmentioning

confidence: 99%

“… 20 However, it is highly professional, and the neck circumference needs to be located by anatomical markers and measured by measuring tools, which will lead to measurement errors, and it is difficult to implement in all clinical departments. 16 …”

Section: Introductionmentioning

confidence: 99%

A Novel Clinical Tool to Detect Severe Obstructive Sleep Apnea

Ye,

Yan,

Huang

et al. 2023

NSS

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Purpose Obstructive sleep apnea (OSA) is a disease with high morbidity and is associated with adverse health outcomes. Screening potential severe OSA patients will improve the quality of patient management and prognosis, while the accuracy and feasibility of existing screening tools are not so satisfactory. The purpose of this study is to develop and validate a well-feasible clinical predictive model for screening potential severe OSA patients. Patients and Methods We performed a retrospective cohort study including 1920 adults with overnight polysomnography among which 979 cases were diagnosed with severe OSA. Based on demography, symptoms, and hematological data, a multivariate logistic regression model was constructed and cross-validated and then a nomogram was developed to identify severe OSA. Moreover, we compared the performance of our model with the most commonly used screening tool, Stop-Bang Questionnaire (SBQ), among patients who completed the questionnaires. Results Severe OSA was associated with male, BMI≥ 28 kg/m 2 , high blood pressure, choke, sleepiness, apnea, white blood cell count ≥9.5×10 9 /L, hemoglobin ≥175g/L, triglycerides ≥1.7 mmol/L. The AUC of the final model was 0.76 (95% CI: 0.74–0.78), with sensitivity and specificity under the optimal threshold selected by maximizing Youden Index of 73% and 66%. Among patients having the information of SBQ, the AUC of our model was statistically significantly greater than that of SBQ (0.78 vs 0.66, P = 0.002). Conclusion Based on common clinical examination of admission, we develop a novel model and a nomogram for identifying severe OSA from inpatient with suspected OSA, which provides physicians with a visual and easy-to-use tool for screening severe OSA.

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Comparison of clinical scores in their ability to detect hypoxemic severe OSA patients

Cited by 10 publications

References 37 publications

Comparative Effectiveness of Sleep Apnea Screening Instruments During Inpatient Rehabilitation Following Moderate to Severe TBI

Comparative Effectiveness of Sleep Apnea Screening Instruments During Inpatient Rehabilitation Following Moderate to Severe TBI

Influence of Different Measurements on the Ability of P-SAP and DES-OSA Scores to Detect Severe Obstructive Sleep Apnea

A Novel Clinical Tool to Detect Severe Obstructive Sleep Apnea

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