SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea.
PROPOSAL:This paper investigates a novel screening tool for Obstructive Sleep Apnea Syndrome (OSAS), which aims at efficient population-wide monitoring. To this end, we introduce SASscore which provides better OSAS prediction specificity while maintaining a high sensitivity. METHODS:We process a coh...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC6124708?pdf=render |
| _version_ | 1818209642605445120 |
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| author | Alexandru Topîrceanu Mihai Udrescu Lucreţia Udrescu Carmen Ardelean Rodica Dan Daniela Reisz Stefan Mihaicuta |
| author_facet | Alexandru Topîrceanu Mihai Udrescu Lucreţia Udrescu Carmen Ardelean Rodica Dan Daniela Reisz Stefan Mihaicuta |
| author_sort | Alexandru Topîrceanu |
| collection | DOAJ |
| description | PROPOSAL:This paper investigates a novel screening tool for Obstructive Sleep Apnea Syndrome (OSAS), which aims at efficient population-wide monitoring. To this end, we introduce SASscore which provides better OSAS prediction specificity while maintaining a high sensitivity. METHODS:We process a cohort of 2595 patients from 4 sleep laboratories in Western Romania, by recording over 100 sleep, breathing, and anthropometric measurements per patient; using this data, we compare our SASscore with state of the art scores STOP-Bang and NoSAS through area under curve (AUC), sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). We also evaluate the performance of SASscore by considering different Apnea-Hypopnea Index (AHI) diagnosis cut-off points and show that custom refinements are possible by changing the score's threshold. RESULTS:SASscore takes decimal values within the interval (2, 7) and varies linearly with AHI; it is based on standardized measures for BMI, neck circumference, systolic blood pressure and Epworth score. By applying the STOP-Bang and NoSAS questionnaires, as well as the SASscore on the patient cohort, we respectively obtain the AUC values of 0.69 (95% CI 0.66-0.73, p < 0.001), 0.66 (95% CI 0.63-0.68, p < 0.001), and 0.73 (95% CI 0.71-0.75, p < 0.001), with sensitivities values of 0.968, 0.901, 0.829, and specificity values of 0.149, 0.294, 0.359, respectively. Additionally, we cross-validate our score with a second independent cohort of 231 patients confirming the high specificity and good sensitivity of our score. When raising SASscore's diagnosis cut-off point from 3 to 3.7, both sensitivity and specificity become roughly 0.6. CONCLUSIONS:In comparison with the existing scores, SASscore is a more appropriate screening tool for monitoring large populations, due to its improved specificity. Our score can be tailored to increase either sensitivity or specificity, while balancing the AUC value. |
| first_indexed | 2024-12-12T05:03:57Z |
| format | Article |
| id | doaj.art-2acc3df5269045a6b751ea438b121318 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T05:03:57Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2acc3df5269045a6b751ea438b1213182022-12-22T00:37:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01139e020204210.1371/journal.pone.0202042SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea.Alexandru TopîrceanuMihai UdrescuLucreţia UdrescuCarmen ArdeleanRodica DanDaniela ReiszStefan MihaicutaPROPOSAL:This paper investigates a novel screening tool for Obstructive Sleep Apnea Syndrome (OSAS), which aims at efficient population-wide monitoring. To this end, we introduce SASscore which provides better OSAS prediction specificity while maintaining a high sensitivity. METHODS:We process a cohort of 2595 patients from 4 sleep laboratories in Western Romania, by recording over 100 sleep, breathing, and anthropometric measurements per patient; using this data, we compare our SASscore with state of the art scores STOP-Bang and NoSAS through area under curve (AUC), sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). We also evaluate the performance of SASscore by considering different Apnea-Hypopnea Index (AHI) diagnosis cut-off points and show that custom refinements are possible by changing the score's threshold. RESULTS:SASscore takes decimal values within the interval (2, 7) and varies linearly with AHI; it is based on standardized measures for BMI, neck circumference, systolic blood pressure and Epworth score. By applying the STOP-Bang and NoSAS questionnaires, as well as the SASscore on the patient cohort, we respectively obtain the AUC values of 0.69 (95% CI 0.66-0.73, p < 0.001), 0.66 (95% CI 0.63-0.68, p < 0.001), and 0.73 (95% CI 0.71-0.75, p < 0.001), with sensitivities values of 0.968, 0.901, 0.829, and specificity values of 0.149, 0.294, 0.359, respectively. Additionally, we cross-validate our score with a second independent cohort of 231 patients confirming the high specificity and good sensitivity of our score. When raising SASscore's diagnosis cut-off point from 3 to 3.7, both sensitivity and specificity become roughly 0.6. CONCLUSIONS:In comparison with the existing scores, SASscore is a more appropriate screening tool for monitoring large populations, due to its improved specificity. Our score can be tailored to increase either sensitivity or specificity, while balancing the AUC value.http://europepmc.org/articles/PMC6124708?pdf=render |
| spellingShingle | Alexandru Topîrceanu Mihai Udrescu Lucreţia Udrescu Carmen Ardelean Rodica Dan Daniela Reisz Stefan Mihaicuta SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea. PLoS ONE |
| title | SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea. |
| title_full | SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea. |
| title_fullStr | SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea. |
| title_full_unstemmed | SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea. |
| title_short | SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea. |
| title_sort | sas score targeting high specificity for efficient population wide monitoring of obstructive sleep apnea |
| url | http://europepmc.org/articles/PMC6124708?pdf=render |
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