Manual scoring of periodic limb movements in children: is it still necessary?
Although manual scoring has been classically considered the gold standard to identify periodic leg movements (PLM), it is a very time consuming and expensive process, also subject to variability in interpretation. In the last decades, different authors have observed reasonably good agreement between...
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| Veröffentlicht in: | Sleep medicine 2024-07, Vol.119, p.229-233 |
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| creator | del-Río Camacho, G. Mahíllo-Fernández, I. García-Martín, L. Blazquez-Domínguez, M. Sánchez-Calle, M. Herrero Huertas, J. Martínez-Cayuelas, E. |
| description | Although manual scoring has been classically considered the gold standard to identify periodic leg movements (PLM), it is a very time consuming and expensive process, also subject to variability in interpretation. In the last decades, different authors have observed reasonably good agreement between automated PSG scoring algorithms and manual scoring in adults, according to established criteria. We aim to compare the automatic software analysis of our polysomnogram with the manual staging in children with sleep-disordered breathing.
We performed a semiautomatic method, in which an experienced technician watched the video recording and removed from the automatic analysis those movements that did not correspond to true candidate leg movement (LM).
A total of 131 PSGs were studied; applying the established criteria, 65 children were diagnosed of obstructive sleep apnea, and 66 presented snoring but with no sleep apnea. The mean age was 6.7 years (±1.7) and twenty-five children (19.08 %) had a PLMI >5/h. Statistical differences were found not only for PLMI (manual: 2.20 (0.7, 4.1) vs automatic (6.4 (3.85,9.5); p |
| doi_str_mv | 10.1016/j.sleep.2024.04.030 |
| format | Article |
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We performed a semiautomatic method, in which an experienced technician watched the video recording and removed from the automatic analysis those movements that did not correspond to true candidate leg movement (LM).
A total of 131 PSGs were studied; applying the established criteria, 65 children were diagnosed of obstructive sleep apnea, and 66 presented snoring but with no sleep apnea. The mean age was 6.7 years (±1.7) and twenty-five children (19.08 %) had a PLMI >5/h. Statistical differences were found not only for PLMI (manual: 2.20 (0.7, 4.1) vs automatic (6.4 (3.85,9.5); p < 0.001), but for almost of all indexes assessed between the automatic and the manual scoring analysis. The level of concordance was only moderate for PLM index (0.63 [0.51–0.72]); showing that, unlike the articles published in the adult population, automatic analysis is not accurate in children and, manually or semi-automatically analysis as ours need to be done.
It seems that PLM detection algorithm might work accurately but, the real need would be a true LM detection algorithm.
•Modern software algorithms can easily identify the periodicity of the leg movements (LM).•However, they fail in the proper identification of these LM, including body movements.•Statistically significant difference was found between manual and automatic staging in children.•Manual staging of LM is still essential, at least in the pediatric population.</description><identifier>ISSN: 1389-9457</identifier><identifier>EISSN: 1878-5506</identifier><identifier>DOI: 10.1016/j.sleep.2024.04.030</identifier><identifier>PMID: 38704870</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Algorithms ; Automatic scoring ; Child ; Child, Preschool ; Female ; Humans ; Male ; Manual scoring ; Nocturnal Myoclonus Syndrome - diagnosis ; Nocturnal Myoclonus Syndrome - physiopathology ; Periodic leg movements ; Polysomnography - methods ; Sleep Apnea, Obstructive - diagnosis ; Sleep Apnea, Obstructive - physiopathology ; Software</subject><ispartof>Sleep medicine, 2024-07, Vol.119, p.229-233</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c309t-7119287267ede753b000ce579ae0e436061193d326317a4d7235dc817560b24e3</cites><orcidid>0000-0003-0558-6541 ; 0000-0002-9401-1864 ; 0000-0001-7375-9657</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1389945724001990$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38704870$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>del-Río Camacho, G.</creatorcontrib><creatorcontrib>Mahíllo-Fernández, I.</creatorcontrib><creatorcontrib>García-Martín, L.</creatorcontrib><creatorcontrib>Blazquez-Domínguez, M.</creatorcontrib><creatorcontrib>Sánchez-Calle, M.</creatorcontrib><creatorcontrib>Herrero Huertas, J.</creatorcontrib><creatorcontrib>Martínez-Cayuelas, E.</creatorcontrib><title>Manual scoring of periodic limb movements in children: is it still necessary?</title><title>Sleep medicine</title><addtitle>Sleep Med</addtitle><description>Although manual scoring has been classically considered the gold standard to identify periodic leg movements (PLM), it is a very time consuming and expensive process, also subject to variability in interpretation. In the last decades, different authors have observed reasonably good agreement between automated PSG scoring algorithms and manual scoring in adults, according to established criteria. We aim to compare the automatic software analysis of our polysomnogram with the manual staging in children with sleep-disordered breathing.
We performed a semiautomatic method, in which an experienced technician watched the video recording and removed from the automatic analysis those movements that did not correspond to true candidate leg movement (LM).
A total of 131 PSGs were studied; applying the established criteria, 65 children were diagnosed of obstructive sleep apnea, and 66 presented snoring but with no sleep apnea. The mean age was 6.7 years (±1.7) and twenty-five children (19.08 %) had a PLMI >5/h. Statistical differences were found not only for PLMI (manual: 2.20 (0.7, 4.1) vs automatic (6.4 (3.85,9.5); p < 0.001), but for almost of all indexes assessed between the automatic and the manual scoring analysis. The level of concordance was only moderate for PLM index (0.63 [0.51–0.72]); showing that, unlike the articles published in the adult population, automatic analysis is not accurate in children and, manually or semi-automatically analysis as ours need to be done.
It seems that PLM detection algorithm might work accurately but, the real need would be a true LM detection algorithm.
•Modern software algorithms can easily identify the periodicity of the leg movements (LM).•However, they fail in the proper identification of these LM, including body movements.•Statistically significant difference was found between manual and automatic staging in children.•Manual staging of LM is still essential, at least in the pediatric population.</description><subject>Algorithms</subject><subject>Automatic scoring</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Manual scoring</subject><subject>Nocturnal Myoclonus Syndrome - diagnosis</subject><subject>Nocturnal Myoclonus Syndrome - physiopathology</subject><subject>Periodic leg movements</subject><subject>Polysomnography - methods</subject><subject>Sleep Apnea, Obstructive - diagnosis</subject><subject>Sleep Apnea, Obstructive - physiopathology</subject><subject>Software</subject><issn>1389-9457</issn><issn>1878-5506</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLAzEQx4MotlY_gSA5etl1kuxudgURKb6gxYuewzaZakr2YbIt-O1NbfUozDAz8JvXn5BzBikDVlyt0uAQ-5QDz1KIJuCAjFkpyyTPoTiMuSirpMpyOSInIawAmGRldkxGopSQRR-T-bxu17WjQXfetu-0W9Ieve2M1dTZZkGbboMNtkOgtqX6wzrjsb2mNtYDDYN1jraoMYTaf92ekqNl7QKe7eOEvD3cv06fktnL4_P0bpZoAdWQSMYqXkpeSDQoc7EAAI25rGoEzEQBRQSEEbwQTNaZkVzkRpdM5gUseIZiQi53c3vffa4xDKqxQaNzdYvdOigBOcu44CWPqNih2ncheFyq3tsmHqsYqK2OaqV-dFRbHRVEExC7LvYL1osGzV_Pr3ARuNkBGN_cWPQqaIutRmM96kGZzv674BsA54Me</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>del-Río Camacho, G.</creator><creator>Mahíllo-Fernández, I.</creator><creator>García-Martín, L.</creator><creator>Blazquez-Domínguez, M.</creator><creator>Sánchez-Calle, M.</creator><creator>Herrero Huertas, J.</creator><creator>Martínez-Cayuelas, E.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0558-6541</orcidid><orcidid>https://orcid.org/0000-0002-9401-1864</orcidid><orcidid>https://orcid.org/0000-0001-7375-9657</orcidid></search><sort><creationdate>202407</creationdate><title>Manual scoring of periodic limb movements in children: is it still necessary?</title><author>del-Río Camacho, G. ; Mahíllo-Fernández, I. ; García-Martín, L. ; Blazquez-Domínguez, M. ; Sánchez-Calle, M. ; Herrero Huertas, J. ; Martínez-Cayuelas, E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c309t-7119287267ede753b000ce579ae0e436061193d326317a4d7235dc817560b24e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Algorithms</topic><topic>Automatic scoring</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Manual scoring</topic><topic>Nocturnal Myoclonus Syndrome - diagnosis</topic><topic>Nocturnal Myoclonus Syndrome - physiopathology</topic><topic>Periodic leg movements</topic><topic>Polysomnography - methods</topic><topic>Sleep Apnea, Obstructive - diagnosis</topic><topic>Sleep Apnea, Obstructive - physiopathology</topic><topic>Software</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>del-Río Camacho, G.</creatorcontrib><creatorcontrib>Mahíllo-Fernández, I.</creatorcontrib><creatorcontrib>García-Martín, L.</creatorcontrib><creatorcontrib>Blazquez-Domínguez, M.</creatorcontrib><creatorcontrib>Sánchez-Calle, M.</creatorcontrib><creatorcontrib>Herrero Huertas, J.</creatorcontrib><creatorcontrib>Martínez-Cayuelas, E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>del-Río Camacho, G.</au><au>Mahíllo-Fernández, I.</au><au>García-Martín, L.</au><au>Blazquez-Domínguez, M.</au><au>Sánchez-Calle, M.</au><au>Herrero Huertas, J.</au><au>Martínez-Cayuelas, E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Manual scoring of periodic limb movements in children: is it still necessary?</atitle><jtitle>Sleep medicine</jtitle><addtitle>Sleep Med</addtitle><date>2024-07</date><risdate>2024</risdate><volume>119</volume><spage>229</spage><epage>233</epage><pages>229-233</pages><issn>1389-9457</issn><eissn>1878-5506</eissn><abstract>Although manual scoring has been classically considered the gold standard to identify periodic leg movements (PLM), it is a very time consuming and expensive process, also subject to variability in interpretation. In the last decades, different authors have observed reasonably good agreement between automated PSG scoring algorithms and manual scoring in adults, according to established criteria. We aim to compare the automatic software analysis of our polysomnogram with the manual staging in children with sleep-disordered breathing.
We performed a semiautomatic method, in which an experienced technician watched the video recording and removed from the automatic analysis those movements that did not correspond to true candidate leg movement (LM).
A total of 131 PSGs were studied; applying the established criteria, 65 children were diagnosed of obstructive sleep apnea, and 66 presented snoring but with no sleep apnea. The mean age was 6.7 years (±1.7) and twenty-five children (19.08 %) had a PLMI >5/h. Statistical differences were found not only for PLMI (manual: 2.20 (0.7, 4.1) vs automatic (6.4 (3.85,9.5); p < 0.001), but for almost of all indexes assessed between the automatic and the manual scoring analysis. The level of concordance was only moderate for PLM index (0.63 [0.51–0.72]); showing that, unlike the articles published in the adult population, automatic analysis is not accurate in children and, manually or semi-automatically analysis as ours need to be done.
It seems that PLM detection algorithm might work accurately but, the real need would be a true LM detection algorithm.
•Modern software algorithms can easily identify the periodicity of the leg movements (LM).•However, they fail in the proper identification of these LM, including body movements.•Statistically significant difference was found between manual and automatic staging in children.•Manual staging of LM is still essential, at least in the pediatric population.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>38704870</pmid><doi>10.1016/j.sleep.2024.04.030</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-0558-6541</orcidid><orcidid>https://orcid.org/0000-0002-9401-1864</orcidid><orcidid>https://orcid.org/0000-0001-7375-9657</orcidid></addata></record> |
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| subjects | Algorithms Automatic scoring Child Child, Preschool Female Humans Male Manual scoring Nocturnal Myoclonus Syndrome - diagnosis Nocturnal Myoclonus Syndrome - physiopathology Periodic leg movements Polysomnography - methods Sleep Apnea, Obstructive - diagnosis Sleep Apnea, Obstructive - physiopathology Software |
| title | Manual scoring of periodic limb movements in children: is it still necessary? |
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