Simulated intention-to-treat analysis based on clinical parameters of patients at high risk for sleep apnea derivated to respiratory polygraphy
Purpose: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAS) is a public health problem. We designed a pilot study to validate empiric indication of CPAP therapy in a population with moderate- to-high pre-test probabilities who underwent self-administered home-based respiratory polygr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2018-09-01
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| Series: | Sleep Science |
| Subjects: | |
| Online Access: | http://sleepscience.org.br/export-pdf/511/ssci-11-03-0160.pdf |
| _version_ | 1797369524878573568 |
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| author | Eduardo Enrique Borsini Magali Blanco Glenda Ernst Paulina Montenegro Alejandro Salvado Carlos Nigro |
| author_facet | Eduardo Enrique Borsini Magali Blanco Glenda Ernst Paulina Montenegro Alejandro Salvado Carlos Nigro |
| author_sort | Eduardo Enrique Borsini |
| collection | DOAJ |
| description | Purpose: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAS) is a public health problem. We
designed a pilot study to validate empiric indication of CPAP therapy in a population with moderate-
to-high pre-test probabilities who underwent self-administered home-based respiratory polygraphy
(RP). Methods: A cross-sectional simulation study was performed. CPAP therapy could be
indicated by two independent blind observers. Observer 1´s decision was based on the results of
STOP-BANG (SBQ) and Epworth Sleepiness Scale (ESS) and Observer 2 used all objective data
provided by RP + SBQ + ESS. Results: We evaluated 1763 patients; 1060 men and 703 women
(39.2%) with a mean age of 53.6±13.8 and a body mass index (BMI) of 32.8±7.5 kg/m2. We found
evidence of mild (34.1%), moderate (26.6%), and severe (18.3%) There were Apnea-Hypopnea
Index (AHI) relationship between > 5 or < 5 SBQ and RP AHI (p<0.05). BMI > 25 kg/m2 +
snoring (S) + observed apnea (O) + 1 of the following: ESS > 11, hypertension (HT) or > 5 SBQ
components showed sensitivity of 40% (CI95%: 37.3-43) and specificity of 95.1% (CI93.4-96.4).
The performance of 5 SBQ components with regard to gender and empirical CPAP therapy was;
(women vs. men): AUC-ROC 0.625 (CI95%: 0.599-0.651) vs. 0.70 (CI95%: 0.68-0.72), p<0.01, respectively.
Conclusions: STOP-BANG and ESS made it possible to indicate CPAP reliably (low
rate of false-positive results) in 20-40% of patients who needed such therapy according to clinical
history and RP results. These clinical criteria performed better in male. |
| first_indexed | 2024-03-08T17:48:05Z |
| format | Article |
| id | doaj.art-67a5a668f8ab472cbbea101ff337b598 |
| institution | Directory Open Access Journal |
| issn | 1984-0659 1984-0063 |
| language | English |
| last_indexed | 2024-03-08T17:48:05Z |
| publishDate | 2018-09-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Sleep Science |
| spelling | doaj.art-67a5a668f8ab472cbbea101ff337b5982024-01-02T10:08:29ZengThieme Revinter Publicações Ltda.Sleep Science1984-06591984-00632018-09-0111316016510.5935/1984-0063.20180030Simulated intention-to-treat analysis based on clinical parameters of patients at high risk for sleep apnea derivated to respiratory polygraphyEduardo Enrique Borsini0Magali Blanco1Glenda Ernst2Paulina Montenegro3Alejandro Salvado4Carlos Nigro5 Hospital Británico de Buenos Aires, Sleep Units - Buenos Aires City - Buenos Aires - Argentina. Hospital Británico de Buenos Aires, Sleep Units - Buenos Aires City - Buenos Aires - Argentina. Hospital Británico de Buenos Aires, Center for Respiratory Medicine - Buenos Aires City - Buenos Aires - Argentina. Hospital Británico de Buenos Aires, Center for Respiratory Medicine - Buenos Aires City - Buenos Aires - Argentina. Hospital Británico de Buenos Aires, Center for Respiratory Medicine - Buenos Aires City - Buenos Aires - Argentina. Hospital Alemán, Sleep Units - Buenos Aires City - Buenos Aires - Argentina.Purpose: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAS) is a public health problem. We designed a pilot study to validate empiric indication of CPAP therapy in a population with moderate- to-high pre-test probabilities who underwent self-administered home-based respiratory polygraphy (RP). Methods: A cross-sectional simulation study was performed. CPAP therapy could be indicated by two independent blind observers. Observer 1´s decision was based on the results of STOP-BANG (SBQ) and Epworth Sleepiness Scale (ESS) and Observer 2 used all objective data provided by RP + SBQ + ESS. Results: We evaluated 1763 patients; 1060 men and 703 women (39.2%) with a mean age of 53.6±13.8 and a body mass index (BMI) of 32.8±7.5 kg/m2. We found evidence of mild (34.1%), moderate (26.6%), and severe (18.3%) There were Apnea-Hypopnea Index (AHI) relationship between > 5 or < 5 SBQ and RP AHI (p<0.05). BMI > 25 kg/m2 + snoring (S) + observed apnea (O) + 1 of the following: ESS > 11, hypertension (HT) or > 5 SBQ components showed sensitivity of 40% (CI95%: 37.3-43) and specificity of 95.1% (CI93.4-96.4). The performance of 5 SBQ components with regard to gender and empirical CPAP therapy was; (women vs. men): AUC-ROC 0.625 (CI95%: 0.599-0.651) vs. 0.70 (CI95%: 0.68-0.72), p<0.01, respectively. Conclusions: STOP-BANG and ESS made it possible to indicate CPAP reliably (low rate of false-positive results) in 20-40% of patients who needed such therapy according to clinical history and RP results. These clinical criteria performed better in male.http://sleepscience.org.br/export-pdf/511/ssci-11-03-0160.pdfSleep Apnea SyndromesContinuous Positive Airway PressureDecision Making |
| spellingShingle | Eduardo Enrique Borsini Magali Blanco Glenda Ernst Paulina Montenegro Alejandro Salvado Carlos Nigro Simulated intention-to-treat analysis based on clinical parameters of patients at high risk for sleep apnea derivated to respiratory polygraphy Sleep Science Sleep Apnea Syndromes Continuous Positive Airway Pressure Decision Making |
| title | Simulated intention-to-treat analysis based on
clinical parameters of patients at high risk for
sleep apnea derivated to respiratory polygraphy |
| title_full | Simulated intention-to-treat analysis based on
clinical parameters of patients at high risk for
sleep apnea derivated to respiratory polygraphy |
| title_fullStr | Simulated intention-to-treat analysis based on
clinical parameters of patients at high risk for
sleep apnea derivated to respiratory polygraphy |
| title_full_unstemmed | Simulated intention-to-treat analysis based on
clinical parameters of patients at high risk for
sleep apnea derivated to respiratory polygraphy |
| title_short | Simulated intention-to-treat analysis based on
clinical parameters of patients at high risk for
sleep apnea derivated to respiratory polygraphy |
| title_sort | simulated intention to treat analysis based on clinical parameters of patients at high risk for sleep apnea derivated to respiratory polygraphy |
| topic | Sleep Apnea Syndromes Continuous Positive Airway Pressure Decision Making |
| url | http://sleepscience.org.br/export-pdf/511/ssci-11-03-0160.pdf |
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