Highlights from the 2018 European Respiratory Society International Congress: sleep and clinical physiology

Almendros, Isaac; Baillieul, Sébastien; Caballero, Candela; Degani-Costa, Luiza Helena; Furian, Michael; Hirotsu, Camila; Louvaris, Zafeiris; Thiel, Sira; Turnbull, Christopher

doi:10.1183/23120541.00201-2018

Cited by 2 publications

(1 citation statement)

References 109 publications

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“…Risk factors for OSA include age, male gender, obesity, neck circumference (NC), abnormal craniofacial features, and female menopause ( Young et al, 2004 ). Early diagnosis of OSA is crucial and untreated OSA may lead to the development of hypertension, cardiovascular disease, type 2 diabetes and neurocognitive dysfunction ( Almendros et al, 2019 ; Tokunou and Ando, 2020 ; Ekin et al, 2021 ; Heilbrunn et al, 2021 ; Yeghiazarians et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Incorporating neck circumference or neck-to-height ratio into the GOAL questionnaire to better detect and describe obstructive sleep apnea with application to clinical decisions

et al. 2022

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ObjectiveAlthough neck circumference (NC) and neck-to-height ratio (NHR) have been recognized as effective predictors of the clinical diagnosis of adult obstructive sleep apnea (OSA), they have not been included in the widely used GOAL questionnaire. Not coincidentally, the NHR has not been adequately considered in the development and validation of the STOP-Bang questionnaire, No-Apnea score and the NoSAS score. The motivation for the study was (1) to combine the GOAL questionnaire with the NC and NHR, respectively, to evaluate its predictive performance and (2) to compare it with the STOP-Bang questionnaire, the No-Apnea score, the NOSAS score, and the GOAL questionnaire.Materials and methodsThis retrospectively allocated cross-sectional study was conducted from November 2017 to March 2022 in adults who underwent nocturnal polysomnography (PSG) or home sleep apnea testing (HSAT). In this paper, the GOAL questionnaire was combined with the NC and NHR, respectively, using logistic regression. The performance of the six screening tools was assessed by discriminatory ability [area under the curve (AUC) obtained from receiver operating characteristic (ROC) curves] and a 2 × 2 league table [including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR−)] and compared under AHI ≥5/h, AHI ≥15/h, and AHI ≥30/h conditions.ResultsA total of 288 patients were enrolled in the study. For all severity OSA levels, the sensitivity of GOAL+NC ranged from 70.12 to 70.80%, and specificity ranged from 86.49 to 76.16%. The sensitivity of GOAL+NHR ranged from 73.31 to 81.75%, while specificity ranged from 83.78 to 70.86%. As for area under the curve (AUC) value under ROC curve, when AHI ≥5/h, compared with GOAL (0.806), No-Apnea (0.823), NoSAS (0.817), and GOAL+NC (0.815), GOAL+NHR (0.831) obtained the highest AUC value, but lower than STOP-Bang (0.837).ConclusionThe predictive power of incorporating NC or NHR into the GOAL questionnaire was significantly better than that of the GOAL itself. Furthermore, GOAL+NHR was superior to GOAL+NC in predicting OSA severity and better than the No-Apnea score and the NoSAS score.

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