Screening for obstructive sleep apnea/hypopnea syndrome: Subjective and objective factors
To determine the sensitivity and specificity of the Berlin Questionnaire and the Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) score for individually predicting a diagnosis of OSAHS, and to propose a method for OSAHS screening incorporating objective and subjective factors. Cross-sectional surve...
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Veröffentlicht in: | Otolaryngology-head and neck surgery 2010-04, Vol.142 (4), p.531-535 |
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creator | Friedman, Michael Wilson, Meghan N. Pulver, Tanya Pandya, Hemang Joseph, Ninos J. Lin, Hsin-Ching Chang, Hsueh-Wen |
description | To determine the sensitivity and specificity of the Berlin Questionnaire and the Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) score for individually predicting a diagnosis of OSAHS, and to propose a method for OSAHS screening incorporating objective and subjective factors.
Cross-sectional survey.
Tertiary care center.
Charts were reviewed from 223 consecutive patients for whom complete data regarding the Berlin questionnaire, OSAHS score (Friedman tongue position + tonsil size + body mass index grade), Epworth Sleepiness Scale, and visual analog scale for snoring were obtained prior to polysomnography (PSG). Sensitivity and specificity were determined for the Berlin questionnaire and OSAHS score for predicting an apnea hypopnea index (AHI) ≥ 5. Patient data were subjected to multivariate stepwise discriminant analysis and used to construct a screening system based on the Fisher's linear classification equation. Results were cross-validated by PSG findings.
In predicting an AHI ≥ 5, the sensitivity and specificity, respectively, were 0.615 and 0.226 for the Berlin questionnaire, 0.863 and 0.468 for OSAHS score, and 0.82 and 0.834 for our predictive equation. When applied case-wise to the study population, this equation correctly predicted 82.5 percent of diagnoses. Accuracy was highest for severe OSAHS (87.4%) and lowest for mild disease (77.0%). Sensitivity was lowest for mild OSAHS (0.50).
Neither the Berlin questionnaire nor the OSAHS score alone was both highly sensitive and specific for diagnosing OSAHS. By incorporating subjective and objective metrics into a single predictive equation, sensitivity and specificity were maximized, and 82.5 percent of diagnoses were accurately predicted. |
doi_str_mv | 10.1016/j.otohns.2009.12.038 |
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Cross-sectional survey.
Tertiary care center.
Charts were reviewed from 223 consecutive patients for whom complete data regarding the Berlin questionnaire, OSAHS score (Friedman tongue position + tonsil size + body mass index grade), Epworth Sleepiness Scale, and visual analog scale for snoring were obtained prior to polysomnography (PSG). Sensitivity and specificity were determined for the Berlin questionnaire and OSAHS score for predicting an apnea hypopnea index (AHI) ≥ 5. Patient data were subjected to multivariate stepwise discriminant analysis and used to construct a screening system based on the Fisher's linear classification equation. Results were cross-validated by PSG findings.
In predicting an AHI ≥ 5, the sensitivity and specificity, respectively, were 0.615 and 0.226 for the Berlin questionnaire, 0.863 and 0.468 for OSAHS score, and 0.82 and 0.834 for our predictive equation. When applied case-wise to the study population, this equation correctly predicted 82.5 percent of diagnoses. Accuracy was highest for severe OSAHS (87.4%) and lowest for mild disease (77.0%). Sensitivity was lowest for mild OSAHS (0.50).
Neither the Berlin questionnaire nor the OSAHS score alone was both highly sensitive and specific for diagnosing OSAHS. By incorporating subjective and objective metrics into a single predictive equation, sensitivity and specificity were maximized, and 82.5 percent of diagnoses were accurately predicted.</description><identifier>ISSN: 0194-5998</identifier><identifier>EISSN: 1097-6817</identifier><identifier>DOI: 10.1016/j.otohns.2009.12.038</identifier><identifier>PMID: 20304273</identifier><language>eng</language><publisher>Los Angeles, CA: Mosby, Inc</publisher><subject>Adolescent ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; Predictive Value of Tests ; Sensitivity and Specificity ; Sleep Apnea, Obstructive - diagnosis ; Snoring ; Surveys and Questionnaires</subject><ispartof>Otolaryngology-head and neck surgery, 2010-04, Vol.142 (4), p.531-535</ispartof><rights>2010 American Academy of Otolaryngology–Head and Neck Surgery Foundation</rights><rights>2010 SAGE Publications</rights><rights>2010 American Association of Otolaryngology‐Head and Neck Surgery Foundation (AAO‐HNSF)</rights><rights>Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4568-967fe957f714ec1cd2f1ff795e137aebb41dc8e3e08ffe30c2ef636ad24583323</citedby><cites>FETCH-LOGICAL-c4568-967fe957f714ec1cd2f1ff795e137aebb41dc8e3e08ffe30c2ef636ad24583323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1016/j.otohns.2009.12.038$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1016/j.otohns.2009.12.038$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,1417,21819,27924,27925,43621,43622,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20304273$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Friedman, Michael</creatorcontrib><creatorcontrib>Wilson, Meghan N.</creatorcontrib><creatorcontrib>Pulver, Tanya</creatorcontrib><creatorcontrib>Pandya, Hemang</creatorcontrib><creatorcontrib>Joseph, Ninos J.</creatorcontrib><creatorcontrib>Lin, Hsin-Ching</creatorcontrib><creatorcontrib>Chang, Hsueh-Wen</creatorcontrib><title>Screening for obstructive sleep apnea/hypopnea syndrome: Subjective and objective factors</title><title>Otolaryngology-head and neck surgery</title><addtitle>Otolaryngol Head Neck Surg</addtitle><description>To determine the sensitivity and specificity of the Berlin Questionnaire and the Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) score for individually predicting a diagnosis of OSAHS, and to propose a method for OSAHS screening incorporating objective and subjective factors.
Cross-sectional survey.
Tertiary care center.
Charts were reviewed from 223 consecutive patients for whom complete data regarding the Berlin questionnaire, OSAHS score (Friedman tongue position + tonsil size + body mass index grade), Epworth Sleepiness Scale, and visual analog scale for snoring were obtained prior to polysomnography (PSG). Sensitivity and specificity were determined for the Berlin questionnaire and OSAHS score for predicting an apnea hypopnea index (AHI) ≥ 5. Patient data were subjected to multivariate stepwise discriminant analysis and used to construct a screening system based on the Fisher's linear classification equation. Results were cross-validated by PSG findings.
In predicting an AHI ≥ 5, the sensitivity and specificity, respectively, were 0.615 and 0.226 for the Berlin questionnaire, 0.863 and 0.468 for OSAHS score, and 0.82 and 0.834 for our predictive equation. When applied case-wise to the study population, this equation correctly predicted 82.5 percent of diagnoses. Accuracy was highest for severe OSAHS (87.4%) and lowest for mild disease (77.0%). Sensitivity was lowest for mild OSAHS (0.50).
Neither the Berlin questionnaire nor the OSAHS score alone was both highly sensitive and specific for diagnosing OSAHS. By incorporating subjective and objective metrics into a single predictive equation, sensitivity and specificity were maximized, and 82.5 percent of diagnoses were accurately predicted.</description><subject>Adolescent</subject><subject>Aged</subject><subject>Body Mass Index</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Polysomnography</subject><subject>Predictive Value of Tests</subject><subject>Sensitivity and Specificity</subject><subject>Sleep Apnea, Obstructive - diagnosis</subject><subject>Snoring</subject><subject>Surveys and Questionnaires</subject><issn>0194-5998</issn><issn>1097-6817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1O3DAURq0KVAbKGyCUHasE_yS2g1AlQAUqobKgXbCyHOcaHGXs1E5A8_bNKNBly8rX0vm-ax0jdERwQTDhp10RxvDsU0ExrgtCC8zkJ7QiuBY5l0TsoBUmdZlXdS330H5KHcaYcyE-oz2KGS6pYCv0-GAigHf-KbMhZqFJY5zM6F4gSz3AkOnBgz593gxhO2Rp49sY1nCWPUxNBwupfTsn329WmzHE9AXtWt0nOHw7D9Cv628_r27zu_ub71cXd7kpKy7zmgsLdSWsICUYYlpqibWiroAwoaFpStIaCQywtBYYNhQsZ1y3tKwkY5QdoJOld4jh9wRpVGuXDPS99hCmpARjEkteypksF9LEkFIEq4bo1jpuFMFq61R1anGqtk4VoWp2OseO3xZMzRrav6F3iTNwvgCvrofNh0rV_e2Py2siGd_2kyWe9BOoLkzRz77-96avSwZmsy8OokrGgTfQujh_g2qD-3fBH12-rvw</recordid><startdate>201004</startdate><enddate>201004</enddate><creator>Friedman, Michael</creator><creator>Wilson, Meghan N.</creator><creator>Pulver, Tanya</creator><creator>Pandya, Hemang</creator><creator>Joseph, Ninos J.</creator><creator>Lin, Hsin-Ching</creator><creator>Chang, Hsueh-Wen</creator><general>Mosby, Inc</general><general>SAGE Publications</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></search><sort><creationdate>201004</creationdate><title>Screening for obstructive sleep apnea/hypopnea syndrome: Subjective and objective factors</title><author>Friedman, Michael ; Wilson, Meghan N. ; Pulver, Tanya ; Pandya, Hemang ; Joseph, Ninos J. ; Lin, Hsin-Ching ; Chang, Hsueh-Wen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4568-967fe957f714ec1cd2f1ff795e137aebb41dc8e3e08ffe30c2ef636ad24583323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Aged</topic><topic>Body Mass Index</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Polysomnography</topic><topic>Predictive Value of Tests</topic><topic>Sensitivity and Specificity</topic><topic>Sleep Apnea, Obstructive - diagnosis</topic><topic>Snoring</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Friedman, Michael</creatorcontrib><creatorcontrib>Wilson, Meghan N.</creatorcontrib><creatorcontrib>Pulver, Tanya</creatorcontrib><creatorcontrib>Pandya, Hemang</creatorcontrib><creatorcontrib>Joseph, Ninos J.</creatorcontrib><creatorcontrib>Lin, Hsin-Ching</creatorcontrib><creatorcontrib>Chang, Hsueh-Wen</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>Otolaryngology-head and neck surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Friedman, Michael</au><au>Wilson, Meghan N.</au><au>Pulver, Tanya</au><au>Pandya, Hemang</au><au>Joseph, Ninos J.</au><au>Lin, Hsin-Ching</au><au>Chang, Hsueh-Wen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Screening for obstructive sleep apnea/hypopnea syndrome: Subjective and objective factors</atitle><jtitle>Otolaryngology-head and neck surgery</jtitle><addtitle>Otolaryngol Head Neck Surg</addtitle><date>2010-04</date><risdate>2010</risdate><volume>142</volume><issue>4</issue><spage>531</spage><epage>535</epage><pages>531-535</pages><issn>0194-5998</issn><eissn>1097-6817</eissn><abstract>To determine the sensitivity and specificity of the Berlin Questionnaire and the Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) score for individually predicting a diagnosis of OSAHS, and to propose a method for OSAHS screening incorporating objective and subjective factors.
Cross-sectional survey.
Tertiary care center.
Charts were reviewed from 223 consecutive patients for whom complete data regarding the Berlin questionnaire, OSAHS score (Friedman tongue position + tonsil size + body mass index grade), Epworth Sleepiness Scale, and visual analog scale for snoring were obtained prior to polysomnography (PSG). Sensitivity and specificity were determined for the Berlin questionnaire and OSAHS score for predicting an apnea hypopnea index (AHI) ≥ 5. Patient data were subjected to multivariate stepwise discriminant analysis and used to construct a screening system based on the Fisher's linear classification equation. Results were cross-validated by PSG findings.
In predicting an AHI ≥ 5, the sensitivity and specificity, respectively, were 0.615 and 0.226 for the Berlin questionnaire, 0.863 and 0.468 for OSAHS score, and 0.82 and 0.834 for our predictive equation. When applied case-wise to the study population, this equation correctly predicted 82.5 percent of diagnoses. Accuracy was highest for severe OSAHS (87.4%) and lowest for mild disease (77.0%). Sensitivity was lowest for mild OSAHS (0.50).
Neither the Berlin questionnaire nor the OSAHS score alone was both highly sensitive and specific for diagnosing OSAHS. By incorporating subjective and objective metrics into a single predictive equation, sensitivity and specificity were maximized, and 82.5 percent of diagnoses were accurately predicted.</abstract><cop>Los Angeles, CA</cop><pub>Mosby, Inc</pub><pmid>20304273</pmid><doi>10.1016/j.otohns.2009.12.038</doi><tpages>5</tpages></addata></record> |
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subjects | Adolescent Aged Body Mass Index Cross-Sectional Studies Female Humans Male Middle Aged Polysomnography Predictive Value of Tests Sensitivity and Specificity Sleep Apnea, Obstructive - diagnosis Snoring Surveys and Questionnaires |
title | Screening for obstructive sleep apnea/hypopnea syndrome: Subjective and objective factors |
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