Modification of McGill Oximetry Score in Improving the Diagnostic Capability of Paediatric OSA

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-08-22 DOI:10.1111/coa.14214

Wannitta E. Ting Wong, Jeyasakthy Saniasiaya, Nur Syazwani Mohd Salehuddin, Shih Ying H'ng, Anna Marie Nathan

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引用次数: 0

Abstract

Objectives

This study aimed to devise a modified oximetry scoring system and calculate its diagnostic accuracy in detecting paediatric obstructive sleep apnoea syndrome (OSAS).

Study Design

This prospective diagnostic accuracy study was divided into two phases.

Setting

The study was conducted at a quaternary teaching hospital.

Methods

Polysomnograms performed from 1 April 2014 to 31 December 2021 were included. In Phase 1, the parameters of 95 oximetry trend graphs were evaluated, and a modified scoring system was constructed. In Phase 2, the modified scoring system was employed in 272 oximetry trend graphs, and its diagnostic accuracy was determined. A logistic regression model was used to assess the ability of each scoring system to predict paediatric OSAS.

Results

A total of 367 patients were recruited. In Phase 1, a four-tier severity classification system was constructed. In Phase 2, its diagnostic accuracy was found to be 53.3% sensitive, 97% specific, with positive predictive value of 98.5% and negative predictive value of 34.6%. The lowest detectable apnoea–hypopnoea index (AHI) was 4.5. The inter-rater reliability calculated was 80%. Logistic regression was applied to assess associations of the modified McGill score (MMS) or McGill oximetry score (MOS) with OSAS. The area under the receiver operating characteristic curve was higher for the MMS than for MOS (0.78 [95% CI 0.73–0.84] vs. 0.59 [95% CI 0.51–0.66]).

Conclusion

This study demonstrated that our modified scoring system had increased sensitivity at detecting OSAS at a much lower AHI and showed a much greater ability to predict paediatric OSAS.

查看原文本刊更多论文

修改麦吉尔血氧饱和度评分以提高儿科 OSA 的诊断能力。

研究目的本研究旨在设计一种改良的血氧饱和度评分系统，并计算其在检测小儿阻塞性睡眠呼吸暂停综合征（OSAS）方面的诊断准确性：这项前瞻性诊断准确性研究分为两个阶段：研究在一家四级教学医院进行：方法：纳入2014年4月1日至2021年12月31日进行的多导睡眠图。在第 1 阶段，对 95 张血氧趋势图的参数进行了评估，并构建了一套修改后的评分系统。在第二阶段，在 272 张血氧趋势图中使用了修改后的评分系统，并确定了其诊断准确性。采用逻辑回归模型评估了每种评分系统预测小儿 OSAS 的能力：结果：共招募了 367 名患者。在第一阶段，建立了四级严重程度分类系统。在第二阶段，该系统的诊断准确率为：敏感性 53.3%，特异性 97%，阳性预测值 98.5%，阴性预测值 34.6%。可检测到的最低呼吸暂停-低通气指数（AHI）为 4.5。计算得出的评分者之间的可靠性为 80%。应用逻辑回归评估改良麦吉尔评分（MMS）或麦吉尔血氧饱和度评分（MOS）与 OSAS 的相关性。MMS的接收器操作特征曲线下面积高于MOS（0.78 [95% CI 0.73-0.84] vs. 0.59 [95% CI 0.51-0.66]）：这项研究表明，我们改进后的评分系统能在更低的 AHI 条件下提高检测 OSAS 的灵敏度，并显示出更强的预测小儿 OSAS 的能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.