A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care
BackgroundTo address the growing burden of disease and long waiting lists for sleep services, a simplified two-stage model was developed and validated for identifying obstructive sleep apnoea (OSA) in primary care using a screening questionnaire followed by home sleep monitoring.Methods157 patients...
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| Veröffentlicht in: | Thorax 2011-03, Vol.66 (3), p.213-219 |
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| creator | Chai-Coetzer, Ching Li Antic, Nick A Rowland, L Sharn Catcheside, Peter G Esterman, Adrian Reed, Richard L Williams, Helena Dunn, Sandra McEvoy, R Doug |
| description | BackgroundTo address the growing burden of disease and long waiting lists for sleep services, a simplified two-stage model was developed and validated for identifying obstructive sleep apnoea (OSA) in primary care using a screening questionnaire followed by home sleep monitoring.Methods157 patients aged 25–70 years attending their primary care physician for any reason at six primary care clinics in rural and metropolitan regions of South Australia participated. The first 79 patients formed the development group and the next 78 patients the validation group. A screening questionnaire was developed from factors identified from sleep surveys, demographic and anthropometric data to be predictive of moderate to severe OSA. Receiver operating characteristic (ROC) curve analysis was used to validate the two-channel ApneaLink device against full polysomnography. The diagnostic accuracy of the overall two-stage model was then evaluated.ResultsSnoring, waist circumference, witnessed apnoeas and age were predictive of OSA and incorporated into a screening questionnaire (ROC area under curve (AUC) 0.84, 95% CI 0.75 to 0.94, p |
| doi_str_mv | 10.1136/thx.2010.152801 |
| format | Article |
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The first 79 patients formed the development group and the next 78 patients the validation group. A screening questionnaire was developed from factors identified from sleep surveys, demographic and anthropometric data to be predictive of moderate to severe OSA. Receiver operating characteristic (ROC) curve analysis was used to validate the two-channel ApneaLink device against full polysomnography. The diagnostic accuracy of the overall two-stage model was then evaluated.ResultsSnoring, waist circumference, witnessed apnoeas and age were predictive of OSA and incorporated into a screening questionnaire (ROC area under curve (AUC) 0.84, 95% CI 0.75 to 0.94, p<0.001). ApneaLink oximetry with a 3% dip rate was highly predictive of OSA (AUC 0.96, 95% CI 0.91 to 1.0, p<0.001). The two-stage diagnostic model showed a sensitivity of 0.97 (95% CI 0.81 to 1.00) and specificity of 0.87 (95% CI 0.74 to 0.95) in the development group, and a sensitivity of 0.88 (95% CI 0.60 to 0.98) and specificity of 0.82 (95% CI 0.70 to 0.90) in the validation group.ConclusionA two-stage model of screening questionnaire followed by home oximetry can accurately identify patients with OSA in primary care and has the potential to expedite care for patients with this common sleep disorder.</description><identifier>ISSN: 0040-6376</identifier><identifier>EISSN: 1468-3296</identifier><identifier>DOI: 10.1136/thx.2010.152801</identifier><identifier>PMID: 21252389</identifier><identifier>CODEN: THORA7</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Thoracic Society</publisher><subject>Accuracy ; Adult ; Age Factors ; Aged ; Anthropometry - methods ; Biological and medical sciences ; Cardiology. Vascular system ; Decision Support Techniques ; diagnosis ; Epidemiologic Methods ; Estimates ; Female ; Health care access ; Home Care Services ; Humans ; Hypertension ; Laboratories ; Male ; Mass Screening - methods ; Medical sciences ; Middle Aged ; Obesity ; Obstructive sleep apnoea ; oximetry ; Physicians ; Pneumology ; Population ; Primary care ; Primary Health Care - methods ; primary healthcare ; Questionnaires ; Respiratory system : syndromes and miscellaneous diseases ; Sleep ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - diagnosis ; sleep apnoea ; Snoring - etiology ; South Australia ; Studies ; Waist Circumference</subject><ispartof>Thorax, 2011-03, Vol.66 (3), p.213-219</ispartof><rights>2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2011 (c) 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b534t-99d7dccdbb2df7cd03c5dce6b024877d031d8129372de10614d6ab0384a0930e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://thorax.bmj.com/content/66/3/213.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://thorax.bmj.com/content/66/3/213.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77343,77374</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23900471$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21252389$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chai-Coetzer, Ching Li</creatorcontrib><creatorcontrib>Antic, Nick A</creatorcontrib><creatorcontrib>Rowland, L Sharn</creatorcontrib><creatorcontrib>Catcheside, Peter G</creatorcontrib><creatorcontrib>Esterman, Adrian</creatorcontrib><creatorcontrib>Reed, Richard L</creatorcontrib><creatorcontrib>Williams, Helena</creatorcontrib><creatorcontrib>Dunn, Sandra</creatorcontrib><creatorcontrib>McEvoy, R Doug</creatorcontrib><title>A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care</title><title>Thorax</title><addtitle>Thorax</addtitle><description>BackgroundTo address the growing burden of disease and long waiting lists for sleep services, a simplified two-stage model was developed and validated for identifying obstructive sleep apnoea (OSA) in primary care using a screening questionnaire followed by home sleep monitoring.Methods157 patients aged 25–70 years attending their primary care physician for any reason at six primary care clinics in rural and metropolitan regions of South Australia participated. The first 79 patients formed the development group and the next 78 patients the validation group. A screening questionnaire was developed from factors identified from sleep surveys, demographic and anthropometric data to be predictive of moderate to severe OSA. Receiver operating characteristic (ROC) curve analysis was used to validate the two-channel ApneaLink device against full polysomnography. The diagnostic accuracy of the overall two-stage model was then evaluated.ResultsSnoring, waist circumference, witnessed apnoeas and age were predictive of OSA and incorporated into a screening questionnaire (ROC area under curve (AUC) 0.84, 95% CI 0.75 to 0.94, p<0.001). ApneaLink oximetry with a 3% dip rate was highly predictive of OSA (AUC 0.96, 95% CI 0.91 to 1.0, p<0.001). The two-stage diagnostic model showed a sensitivity of 0.97 (95% CI 0.81 to 1.00) and specificity of 0.87 (95% CI 0.74 to 0.95) in the development group, and a sensitivity of 0.88 (95% CI 0.60 to 0.98) and specificity of 0.82 (95% CI 0.70 to 0.90) in the validation group.ConclusionA two-stage model of screening questionnaire followed by home oximetry can accurately identify patients with OSA in primary care and has the potential to expedite care for patients with this common sleep disorder.</description><subject>Accuracy</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Anthropometry - methods</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Decision Support Techniques</subject><subject>diagnosis</subject><subject>Epidemiologic Methods</subject><subject>Estimates</subject><subject>Female</subject><subject>Health care access</subject><subject>Home Care Services</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Laboratories</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obstructive sleep apnoea</subject><subject>oximetry</subject><subject>Physicians</subject><subject>Pneumology</subject><subject>Population</subject><subject>Primary care</subject><subject>Primary Health Care - methods</subject><subject>primary healthcare</subject><subject>Questionnaires</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Sleep</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - diagnosis</subject><subject>sleep apnoea</subject><subject>Snoring - etiology</subject><subject>South Australia</subject><subject>Studies</subject><subject>Waist Circumference</subject><issn>0040-6376</issn><issn>1468-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkduL1DAUh4Mo7jj67JsERAShu7m0Sfq4DN5g8AIqvoU0OXUztsls0sr635vacQVffEoO-fLjnPMh9JiSc0q5uJiubs4ZWaqGKULvoA2thao4a8VdtCGkJpXgUpyhBzkfCCGKUnkfnTHKGsZVu0HhEmc_Hgffe3B4jA4GHHucbQIIPnzD1zPkyccQjE-ATXD4Ko5QyOCnmBaijwnHLk9ptpP_ATgPAEdsjiGCwT7gY_KjST-xNQkeonu9GTI8Op1b9PnVy0-7N9X-_eu3u8t91TW8nqq2ddJZ67qOuV5aR7htnAXREVYrKUtNnaKs5ZI5oETQ2gnTEa5qQ1pOgG_R8zX3mOLvCfTos4VhMAHinLVqOGOCNrSQT_8hD3FOoTSnqVRUkbYpq9qii5WyKeacoNenqTQlejGhiwm9mNCrifLjySl37kZwt_yf1Rfg2Qkw2ZqhTyZYn_9yvC365BJUrZzPE9zcvpv0XQvJZaPffdnpj1_3SnxQ5VL4FyvfjYf_dvkL_HKuIw</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Chai-Coetzer, Ching Li</creator><creator>Antic, Nick A</creator><creator>Rowland, L Sharn</creator><creator>Catcheside, Peter G</creator><creator>Esterman, Adrian</creator><creator>Reed, Richard L</creator><creator>Williams, Helena</creator><creator>Dunn, Sandra</creator><creator>McEvoy, R Doug</creator><general>BMJ Publishing Group Ltd and British Thoracic Society</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care</title><author>Chai-Coetzer, Ching Li ; Antic, Nick A ; Rowland, L Sharn ; Catcheside, Peter G ; Esterman, Adrian ; Reed, Richard L ; Williams, Helena ; Dunn, Sandra ; McEvoy, R Doug</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b534t-99d7dccdbb2df7cd03c5dce6b024877d031d8129372de10614d6ab0384a0930e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Accuracy</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Anthropometry - methods</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Decision Support Techniques</topic><topic>diagnosis</topic><topic>Epidemiologic Methods</topic><topic>Estimates</topic><topic>Female</topic><topic>Health care access</topic><topic>Home Care Services</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Laboratories</topic><topic>Male</topic><topic>Mass Screening - methods</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obstructive sleep apnoea</topic><topic>oximetry</topic><topic>Physicians</topic><topic>Pneumology</topic><topic>Population</topic><topic>Primary care</topic><topic>Primary Health Care - methods</topic><topic>primary healthcare</topic><topic>Questionnaires</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Sleep</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - diagnosis</topic><topic>sleep apnoea</topic><topic>Snoring - etiology</topic><topic>South Australia</topic><topic>Studies</topic><topic>Waist Circumference</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chai-Coetzer, Ching Li</creatorcontrib><creatorcontrib>Antic, Nick A</creatorcontrib><creatorcontrib>Rowland, L Sharn</creatorcontrib><creatorcontrib>Catcheside, Peter G</creatorcontrib><creatorcontrib>Esterman, Adrian</creatorcontrib><creatorcontrib>Reed, Richard L</creatorcontrib><creatorcontrib>Williams, Helena</creatorcontrib><creatorcontrib>Dunn, Sandra</creatorcontrib><creatorcontrib>McEvoy, R Doug</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Thorax</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chai-Coetzer, Ching Li</au><au>Antic, Nick A</au><au>Rowland, L Sharn</au><au>Catcheside, Peter G</au><au>Esterman, Adrian</au><au>Reed, Richard L</au><au>Williams, Helena</au><au>Dunn, Sandra</au><au>McEvoy, R Doug</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care</atitle><jtitle>Thorax</jtitle><addtitle>Thorax</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>66</volume><issue>3</issue><spage>213</spage><epage>219</epage><pages>213-219</pages><issn>0040-6376</issn><eissn>1468-3296</eissn><coden>THORA7</coden><abstract>BackgroundTo address the growing burden of disease and long waiting lists for sleep services, a simplified two-stage model was developed and validated for identifying obstructive sleep apnoea (OSA) in primary care using a screening questionnaire followed by home sleep monitoring.Methods157 patients aged 25–70 years attending their primary care physician for any reason at six primary care clinics in rural and metropolitan regions of South Australia participated. The first 79 patients formed the development group and the next 78 patients the validation group. A screening questionnaire was developed from factors identified from sleep surveys, demographic and anthropometric data to be predictive of moderate to severe OSA. Receiver operating characteristic (ROC) curve analysis was used to validate the two-channel ApneaLink device against full polysomnography. The diagnostic accuracy of the overall two-stage model was then evaluated.ResultsSnoring, waist circumference, witnessed apnoeas and age were predictive of OSA and incorporated into a screening questionnaire (ROC area under curve (AUC) 0.84, 95% CI 0.75 to 0.94, p<0.001). ApneaLink oximetry with a 3% dip rate was highly predictive of OSA (AUC 0.96, 95% CI 0.91 to 1.0, p<0.001). The two-stage diagnostic model showed a sensitivity of 0.97 (95% CI 0.81 to 1.00) and specificity of 0.87 (95% CI 0.74 to 0.95) in the development group, and a sensitivity of 0.88 (95% CI 0.60 to 0.98) and specificity of 0.82 (95% CI 0.70 to 0.90) in the validation group.ConclusionA two-stage model of screening questionnaire followed by home oximetry can accurately identify patients with OSA in primary care and has the potential to expedite care for patients with this common sleep disorder.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Thoracic Society</pub><pmid>21252389</pmid><doi>10.1136/thx.2010.152801</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Accuracy Adult Age Factors Aged Anthropometry - methods Biological and medical sciences Cardiology. Vascular system Decision Support Techniques diagnosis Epidemiologic Methods Estimates Female Health care access Home Care Services Humans Hypertension Laboratories Male Mass Screening - methods Medical sciences Middle Aged Obesity Obstructive sleep apnoea oximetry Physicians Pneumology Population Primary care Primary Health Care - methods primary healthcare Questionnaires Respiratory system : syndromes and miscellaneous diseases Sleep Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - diagnosis sleep apnoea Snoring - etiology South Australia Studies Waist Circumference |
| title | A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care |
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