Andrej Pangerc, Marija Petek Šter, Leja Dolenc Grošelj
{"title":"在基层医疗机构对阻塞性睡眠呼吸暂停进行两阶段筛查","authors":"Andrej Pangerc, Marija Petek Šter, Leja Dolenc Grošelj","doi":"10.1007/s11325-024-03142-w","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To evaluate the effectiveness of a two-stage screening model for obstructive sleep apnea (OSA) in primary care that combines the STOP-BANG questionnaire (SBQ) with an automated home sleep apnea test (HSAT).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This cross-sectional study was conducted from August 2018 to August 2022 in four Slovenian primary care practices. It included 153 randomly selected patients aged 18 to 70 years who visited the practice for any reason. Participants completed the SBQ and underwent HSAT with type III polygraphy on the same night. The HSAT recordings were scored automatically and by an experienced, accredited somnologist.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>There was a strong correlation between manual and automated HSAT scorings for the detection of OSA (Pearson’s r = 0.93). Cohen’s kappa was 0.80 for OSA (respiratory event index (REI) ≥ 5) and 0.77 for OSA severity categorization. The two-stage model demonstrated sensitivity of 64%, a specificity of 97.4%, a positive predictive value (PPV) of 96.0%, a negative predictive value (NPV) of 73.8% and an accuracy of 81.1% for any OSA (REI ≥ 5). For moderate to severe OSA (REI ≥ 15), the model showed 72.7% sensitivity, 96.7% specificity, 85.7% PPV, 92.8% NPV and 91.5% accuracy.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The two-stage model for OSA screening combining the SBQ and automated HSAT was shown to be effective in primary care, especially for moderate and severe OSA. This method provides a practical and efficient approach for the early detection of OSA.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Two-stage screening for obstructive sleep apnea in the primary practice setting\",\"authors\":\"Andrej Pangerc, Marija Petek Šter, Leja Dolenc Grošelj\",\"doi\":\"10.1007/s11325-024-03142-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose</h3><p>To evaluate the effectiveness of a two-stage screening model for obstructive sleep apnea (OSA) in primary care that combines the STOP-BANG questionnaire (SBQ) with an automated home sleep apnea test (HSAT).</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>This cross-sectional study was conducted from August 2018 to August 2022 in four Slovenian primary care practices. It included 153 randomly selected patients aged 18 to 70 years who visited the practice for any reason. Participants completed the SBQ and underwent HSAT with type III polygraphy on the same night. The HSAT recordings were scored automatically and by an experienced, accredited somnologist.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>There was a strong correlation between manual and automated HSAT scorings for the detection of OSA (Pearson’s r = 0.93). Cohen’s kappa was 0.80 for OSA (respiratory event index (REI) ≥ 5) and 0.77 for OSA severity categorization. The two-stage model demonstrated sensitivity of 64%, a specificity of 97.4%, a positive predictive value (PPV) of 96.0%, a negative predictive value (NPV) of 73.8% and an accuracy of 81.1% for any OSA (REI ≥ 5). For moderate to severe OSA (REI ≥ 15), the model showed 72.7% sensitivity, 96.7% specificity, 85.7% PPV, 92.8% NPV and 91.5% accuracy.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusions</h3><p>The two-stage model for OSA screening combining the SBQ and automated HSAT was shown to be effective in primary care, especially for moderate and severe OSA. 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Two-stage screening for obstructive sleep apnea in the primary practice setting
Purpose
To evaluate the effectiveness of a two-stage screening model for obstructive sleep apnea (OSA) in primary care that combines the STOP-BANG questionnaire (SBQ) with an automated home sleep apnea test (HSAT).
Methods
This cross-sectional study was conducted from August 2018 to August 2022 in four Slovenian primary care practices. It included 153 randomly selected patients aged 18 to 70 years who visited the practice for any reason. Participants completed the SBQ and underwent HSAT with type III polygraphy on the same night. The HSAT recordings were scored automatically and by an experienced, accredited somnologist.
Results
There was a strong correlation between manual and automated HSAT scorings for the detection of OSA (Pearson’s r = 0.93). Cohen’s kappa was 0.80 for OSA (respiratory event index (REI) ≥ 5) and 0.77 for OSA severity categorization. The two-stage model demonstrated sensitivity of 64%, a specificity of 97.4%, a positive predictive value (PPV) of 96.0%, a negative predictive value (NPV) of 73.8% and an accuracy of 81.1% for any OSA (REI ≥ 5). For moderate to severe OSA (REI ≥ 15), the model showed 72.7% sensitivity, 96.7% specificity, 85.7% PPV, 92.8% NPV and 91.5% accuracy.
Conclusions
The two-stage model for OSA screening combining the SBQ and automated HSAT was shown to be effective in primary care, especially for moderate and severe OSA. This method provides a practical and efficient approach for the early detection of OSA.
期刊介绍:
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.