Diagnostic accuracy of current glossoptosis classification systems: A nested cohort cross‐sectional study
Objectives/Hypothesis To assess the performance of endoscopic grading systems of glossoptosis in identifying severe clinical manifestations in children with Robin sequence (RS). Study Design Nested cohort cross‐sectional study. Methods All RS patients diagnosed at Hospital Clinics of Porto Alegre fr...
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| Veröffentlicht in: | The Laryngoscope 2018-02, Vol.128 (2), p.502-508 |
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| container_title | The Laryngoscope |
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| creator | Manica, Denise Schweiger, Cláudia Sekine, Leo Fagondes, Simone Chaves Kuhl, Gabriel Vinicius Collares, Marcus Marostica, Paulo José Cauduro |
| description | Objectives/Hypothesis
To assess the performance of endoscopic grading systems of glossoptosis in identifying severe clinical manifestations in children with Robin sequence (RS).
Study Design
Nested cohort cross‐sectional study.
Methods
All RS patients diagnosed at Hospital Clinics of Porto Alegre from October 2012 to June 2016 were enrolled in this cohort. Patients underwent sleep endoscopy and were classified according to Yellon (Y) and de Sousa et al. (S) scales. Symptom severity evaluation was performed as defined by Cole et al. The outcome of interest was Cole's clinical classification grade 3.
Results
Eighty patients were eligible for analysis. Sensitivity (Y: 56.2%, S: 28.1%, P |
| doi_str_mv | 10.1002/lary.26882 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1942706254</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1988036461</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3572-53b4476bf1a9f5551cc7e4c9906a0773f25b565526db6f41841d3f0e54b0921b3</originalsourceid><addsrcrecordid>eNp90c9LHDEUB_BQlLquXvoHSMCLCGPze2Z6W7bVFhYKxUI9DZlMYrOdnax5M8jc_BP8G_uXmHVXDx485UE--fLyHkKfKLmghLDPrY7jBVNFwT6gCZWcZqIs5R6apEueFZL9OUCHAEtCaM4l-YgOWFEKwhmdoH9fvb7tAvTeYG3MELUZcXA4VdF2Pb5tA0BY9wE8YNNqAO-80b0PHYYReruCL3iGO5vKBpvwN8Qem5ge_X94BGs2ULcY-qEZj9C-0y3Y4905Rb8vv13Pv2eLn1c_5rNFZrjMWSZ5LUSuakd16aSU1JjcClOWRGmS59wxWUslJVNNrZyghaANd8RKUZOS0ZpP0dk2dx3D3ZA6q1YejG1b3dkwQEVLwXKimBSJnr6hyzDE1PFGFQXhSiia1PlWPX8sWleto1-lqVeUVJsVVJsVVM8rSPhkFznUK9u80peZJ0C34N63dnwnqlrMft1sQ58AQ1WTMw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1988036461</pqid></control><display><type>article</type><title>Diagnostic accuracy of current glossoptosis classification systems: A nested cohort cross‐sectional study</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Manica, Denise ; Schweiger, Cláudia ; Sekine, Leo ; Fagondes, Simone Chaves ; Kuhl, Gabriel ; Vinicius Collares, Marcus ; Marostica, Paulo José Cauduro</creator><creatorcontrib>Manica, Denise ; Schweiger, Cláudia ; Sekine, Leo ; Fagondes, Simone Chaves ; Kuhl, Gabriel ; Vinicius Collares, Marcus ; Marostica, Paulo José Cauduro</creatorcontrib><description>Objectives/Hypothesis
To assess the performance of endoscopic grading systems of glossoptosis in identifying severe clinical manifestations in children with Robin sequence (RS).
Study Design
Nested cohort cross‐sectional study.
Methods
All RS patients diagnosed at Hospital Clinics of Porto Alegre from October 2012 to June 2016 were enrolled in this cohort. Patients underwent sleep endoscopy and were classified according to Yellon (Y) and de Sousa et al. (S) scales. Symptom severity evaluation was performed as defined by Cole et al. The outcome of interest was Cole's clinical classification grade 3.
Results
Eighty patients were eligible for analysis. Sensitivity (Y: 56.2%, S: 28.1%, P < .001) and specificity (Y: 85.4%, S: 93.8%, P = .038) in identifying severe clinical symptoms patients (i.e., Cole grade 3) were statistically different between Y and S classifications. A low but significant overall correlation was observed for both Y (rho = 0.372, P < .001) and S (rho = 0.439, P < .001) classifications when compared with Cole classification. Diagnostic odds ratio (DOR) for Y (DOR: 7.53, 95% confidence interval [CI]: 4.15‐10.90) and S (DOR: 5.87, 95% CI: 1.86‐9.87) were equivalent (P = .92). Also, receiver operating characteristic curves area under the curve were not significantly different between them. The positive likelihood ratio was 3.86 (95% CI: 1.82‐8.16) and 4.50 (95% CI: 1.32‐15.36) for Y and S, respectively.
Conclusions
Y and S grading systems showed a low sensitivity and moderate to high specificity in detecting patients with severe clinical manifestations. Correlation between Y/S and Cole et al. grading were also considered low. Development of a more discriminative anatomic grading system is still needed for this specific disorder.
Level of Evidence
2b. Laryngoscope, 128:502–508, 2018</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.26882</identifier><identifier>PMID: 28940321</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Cross-sectional studies ; Glossoptosis ; laryngoscopy ; micrognathism ; Pierre Robin syndrome ; respiratory sounds</subject><ispartof>The Laryngoscope, 2018-02, Vol.128 (2), p.502-508</ispartof><rights>2017 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2018 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3572-53b4476bf1a9f5551cc7e4c9906a0773f25b565526db6f41841d3f0e54b0921b3</citedby><cites>FETCH-LOGICAL-c3572-53b4476bf1a9f5551cc7e4c9906a0773f25b565526db6f41841d3f0e54b0921b3</cites><orcidid>0000-0002-2438-3355</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.26882$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.26882$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28940321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manica, Denise</creatorcontrib><creatorcontrib>Schweiger, Cláudia</creatorcontrib><creatorcontrib>Sekine, Leo</creatorcontrib><creatorcontrib>Fagondes, Simone Chaves</creatorcontrib><creatorcontrib>Kuhl, Gabriel</creatorcontrib><creatorcontrib>Vinicius Collares, Marcus</creatorcontrib><creatorcontrib>Marostica, Paulo José Cauduro</creatorcontrib><title>Diagnostic accuracy of current glossoptosis classification systems: A nested cohort cross‐sectional study</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis
To assess the performance of endoscopic grading systems of glossoptosis in identifying severe clinical manifestations in children with Robin sequence (RS).
Study Design
Nested cohort cross‐sectional study.
Methods
All RS patients diagnosed at Hospital Clinics of Porto Alegre from October 2012 to June 2016 were enrolled in this cohort. Patients underwent sleep endoscopy and were classified according to Yellon (Y) and de Sousa et al. (S) scales. Symptom severity evaluation was performed as defined by Cole et al. The outcome of interest was Cole's clinical classification grade 3.
Results
Eighty patients were eligible for analysis. Sensitivity (Y: 56.2%, S: 28.1%, P < .001) and specificity (Y: 85.4%, S: 93.8%, P = .038) in identifying severe clinical symptoms patients (i.e., Cole grade 3) were statistically different between Y and S classifications. A low but significant overall correlation was observed for both Y (rho = 0.372, P < .001) and S (rho = 0.439, P < .001) classifications when compared with Cole classification. Diagnostic odds ratio (DOR) for Y (DOR: 7.53, 95% confidence interval [CI]: 4.15‐10.90) and S (DOR: 5.87, 95% CI: 1.86‐9.87) were equivalent (P = .92). Also, receiver operating characteristic curves area under the curve were not significantly different between them. The positive likelihood ratio was 3.86 (95% CI: 1.82‐8.16) and 4.50 (95% CI: 1.32‐15.36) for Y and S, respectively.
Conclusions
Y and S grading systems showed a low sensitivity and moderate to high specificity in detecting patients with severe clinical manifestations. Correlation between Y/S and Cole et al. grading were also considered low. Development of a more discriminative anatomic grading system is still needed for this specific disorder.
Level of Evidence
2b. Laryngoscope, 128:502–508, 2018</description><subject>Cross-sectional studies</subject><subject>Glossoptosis</subject><subject>laryngoscopy</subject><subject>micrognathism</subject><subject>Pierre Robin syndrome</subject><subject>respiratory sounds</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp90c9LHDEUB_BQlLquXvoHSMCLCGPze2Z6W7bVFhYKxUI9DZlMYrOdnax5M8jc_BP8G_uXmHVXDx485UE--fLyHkKfKLmghLDPrY7jBVNFwT6gCZWcZqIs5R6apEueFZL9OUCHAEtCaM4l-YgOWFEKwhmdoH9fvb7tAvTeYG3MELUZcXA4VdF2Pb5tA0BY9wE8YNNqAO-80b0PHYYReruCL3iGO5vKBpvwN8Qem5ge_X94BGs2ULcY-qEZj9C-0y3Y4905Rb8vv13Pv2eLn1c_5rNFZrjMWSZ5LUSuakd16aSU1JjcClOWRGmS59wxWUslJVNNrZyghaANd8RKUZOS0ZpP0dk2dx3D3ZA6q1YejG1b3dkwQEVLwXKimBSJnr6hyzDE1PFGFQXhSiia1PlWPX8sWleto1-lqVeUVJsVVJsVVM8rSPhkFznUK9u80peZJ0C34N63dnwnqlrMft1sQ58AQ1WTMw</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Manica, Denise</creator><creator>Schweiger, Cláudia</creator><creator>Sekine, Leo</creator><creator>Fagondes, Simone Chaves</creator><creator>Kuhl, Gabriel</creator><creator>Vinicius Collares, Marcus</creator><creator>Marostica, Paulo José Cauduro</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2438-3355</orcidid></search><sort><creationdate>201802</creationdate><title>Diagnostic accuracy of current glossoptosis classification systems: A nested cohort cross‐sectional study</title><author>Manica, Denise ; Schweiger, Cláudia ; Sekine, Leo ; Fagondes, Simone Chaves ; Kuhl, Gabriel ; Vinicius Collares, Marcus ; Marostica, Paulo José Cauduro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3572-53b4476bf1a9f5551cc7e4c9906a0773f25b565526db6f41841d3f0e54b0921b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Cross-sectional studies</topic><topic>Glossoptosis</topic><topic>laryngoscopy</topic><topic>micrognathism</topic><topic>Pierre Robin syndrome</topic><topic>respiratory sounds</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manica, Denise</creatorcontrib><creatorcontrib>Schweiger, Cláudia</creatorcontrib><creatorcontrib>Sekine, Leo</creatorcontrib><creatorcontrib>Fagondes, Simone Chaves</creatorcontrib><creatorcontrib>Kuhl, Gabriel</creatorcontrib><creatorcontrib>Vinicius Collares, Marcus</creatorcontrib><creatorcontrib>Marostica, Paulo José Cauduro</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manica, Denise</au><au>Schweiger, Cláudia</au><au>Sekine, Leo</au><au>Fagondes, Simone Chaves</au><au>Kuhl, Gabriel</au><au>Vinicius Collares, Marcus</au><au>Marostica, Paulo José Cauduro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic accuracy of current glossoptosis classification systems: A nested cohort cross‐sectional study</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2018-02</date><risdate>2018</risdate><volume>128</volume><issue>2</issue><spage>502</spage><epage>508</epage><pages>502-508</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
To assess the performance of endoscopic grading systems of glossoptosis in identifying severe clinical manifestations in children with Robin sequence (RS).
Study Design
Nested cohort cross‐sectional study.
Methods
All RS patients diagnosed at Hospital Clinics of Porto Alegre from October 2012 to June 2016 were enrolled in this cohort. Patients underwent sleep endoscopy and were classified according to Yellon (Y) and de Sousa et al. (S) scales. Symptom severity evaluation was performed as defined by Cole et al. The outcome of interest was Cole's clinical classification grade 3.
Results
Eighty patients were eligible for analysis. Sensitivity (Y: 56.2%, S: 28.1%, P < .001) and specificity (Y: 85.4%, S: 93.8%, P = .038) in identifying severe clinical symptoms patients (i.e., Cole grade 3) were statistically different between Y and S classifications. A low but significant overall correlation was observed for both Y (rho = 0.372, P < .001) and S (rho = 0.439, P < .001) classifications when compared with Cole classification. Diagnostic odds ratio (DOR) for Y (DOR: 7.53, 95% confidence interval [CI]: 4.15‐10.90) and S (DOR: 5.87, 95% CI: 1.86‐9.87) were equivalent (P = .92). Also, receiver operating characteristic curves area under the curve were not significantly different between them. The positive likelihood ratio was 3.86 (95% CI: 1.82‐8.16) and 4.50 (95% CI: 1.32‐15.36) for Y and S, respectively.
Conclusions
Y and S grading systems showed a low sensitivity and moderate to high specificity in detecting patients with severe clinical manifestations. Correlation between Y/S and Cole et al. grading were also considered low. Development of a more discriminative anatomic grading system is still needed for this specific disorder.
Level of Evidence
2b. Laryngoscope, 128:502–508, 2018</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28940321</pmid><doi>10.1002/lary.26882</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2438-3355</orcidid></addata></record> |
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| subjects | Cross-sectional studies Glossoptosis laryngoscopy micrognathism Pierre Robin syndrome respiratory sounds |
| title | Diagnostic accuracy of current glossoptosis classification systems: A nested cohort cross‐sectional study |
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