"The M-APNE score: an objective screening tool for OSA highlighting the area under the inspiratory flow-volume curve".

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2025-01-14 DOI:10.1007/s11325-024-03239-2

Celal Satici, Damla Azakli, Sinem Nedime Sokucu, Senay Aydin, Furkan Atasever, Cengiz Ozdemir

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引用次数: 0

Abstract

Background: Polysomnography (PSG) is resource-intensive but remains the gold standard for diagnosing Obstructive Sleep Apnea (OSA). We aimed to develop a screening tool to better allocate resources by identifying individuals at higher risk for OSA, overcoming limitations of current tools that may under-diagnose based on self-reported symptoms.

Methods: A total of 884 patients (490 diagnosed with OSA) were included, which was divided into the training, validation, and test sets. Using multivariate logistic regression analyses, we developed a scoring system incorporating male sex, age, sawtooth pattern, area under the inspiratory flow-volume curve (AreaFI), and neck circumference to objectively identify patients at higher risk of OSA. Sensitivity and specificity were evaluated using area under the curve (AUC) metrics. The M-APNE Score was compared to other non-symptom-based tools, the No-Apnea Score and the Symptomless Multivariable Apnea Prediction (sMVAP) model, using the Delong test.

Results: The M-APNE Score showed sensitivity rates of 79.3% in the training set, 70.8% in the test, and 80% in the validation set. ROC analysis for M-APNE score yielded AUCs of 0.82 in the training, 0.76 in the test, 0.82 in the validation set. The discriminative accuracy of M-APNE Score were found to be better than the No-Apnea Score (AUC = 0.82 vs. 0.76, p < 0.001) and the sMVAP (AUC = 0.82 vs. 0.75, p = 0.001) in the training set. Hosmer Lemeshow test indicated good calibration for M-Apne Score (p = 0.46).

Conclusions: The M-APNE Score is a robust and objective tool for OSA screening, potentially reducing classification errors and improving accuracy.

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"M-APNE评分：突出吸气流量-容积曲线下面积的OSA客观筛查工具"。

背景：多导睡眠图（PSG）是资源密集型的，但仍然是诊断阻塞性睡眠呼吸暂停（OSA）的金标准。我们的目标是开发一种筛选工具，通过识别OSA高风险个体来更好地分配资源，克服现有工具可能基于自我报告症状诊断不足的局限性。方法：共纳入884例OSA患者（确诊患者490例），分为训练组、验证组和测试组。通过多变量logistic回归分析，我们建立了一个评分系统，包括男性性别、年龄、锯齿形、吸气流量-体积曲线下面积（AreaFI）和颈围，以客观地识别OSA高风险患者。使用曲线下面积（AUC）指标评估敏感性和特异性。使用Delong检验将M-APNE评分与其他非基于症状的工具、无呼吸暂停评分和无症状多变量呼吸暂停预测（sMVAP）模型进行比较。结果：M-APNE评分对训练集的敏感性为79.3%，对测试集的敏感性为70.8%，对验证集的敏感性为80%。M-APNE评分的ROC分析结果显示，训练组的auc为0.82，测试组为0.76，验证组为0.82。M-APNE评分的判别准确率优于No-Apnea评分（AUC = 0.82 vs. 0.76, p）。结论：M-APNE评分是OSA筛查的一种可靠、客观的工具，有可能减少分类错误并提高准确性。

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

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

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.