Sherri L Katz, Taylor Barwell, Vid Bijelić, Nicholas Barrowman, Henrietta Blinder, Naomi Dussah, Roya Shamsi, Alexa R Leitman, Refika Ersu
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引用次数: 0
Abstract
Background: Diagnosing obstructive sleep apnea (OSA) in children is challenging, with long wait times for polysomnography (PSG). This study assessed the diagnostic accuracy of home-recorded video clips for OSA compared to PSG.
Methods: Children (2-18 years) referred for PSG for suspected OSA were enrolled. Parents recorded video clips of their child sleeping and completed the Pediatric Sleep Questionnaire (PSQ). Blinded clinicians scored videos using the Monash Obstructive Sleep Apnea score (MS). Participants underwent PSG, and outcomes included obstructive apnea-hypopnea index (OAHI) and oximetry metrics (i.e., McGill Oximetry Score [MOS]; 3% Oxygen Desaturation Index [ODI3]). Diagnostic characteristics of MS, PSQ, MOS, and ODI3 were compared for detection of any (OAHI ≥ 1.5 events/h) and moderate-severe OSA (OAHI ≥ 5 events/h).
Results: Forty-one children (age 7.0 years, 49% female) participated. Median OAHI was 0.6 events/h (IQR 0.3, 3.1); 16 (39%) had OAHI ≥ 1.5 events/h, 5 (12%) had OAHI ≥ 5 events/h. PSQ identified 36 (88%) participants with a score ≥ 0.33. One child had MOS ≥ 2; ODI3 was ≥ 4.3 in 8 (20%) and > 7 in 6 (15%). Mean MS was 3.6 (SD 2.1). MS had 81.2% sensitivity and 52.0% specificity for any OSA and 100% sensitivity and 44.4% specificity for moderate-severe OSA. A combination of MS and ODI3 improved diagnostic accuracy with an AUC of 98.3.
Conclusion: MS demonstrated high sensitivity but low specificity for the detection of moderate-severe OSA. Video scores outperformed PSQ but were less accurate than oximetry. Combining MS and ODI3 yielded the strongest diagnostic characteristics. Video scores may aid in pediatric OSA screening.
期刊介绍：
Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases.
PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
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