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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 polygraphy (RP). METHODS:...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Brazilian Association of Sleep and Latin American Federation of
Sleep
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201519/ https://www.ncbi.nlm.nih.gov/pubmed/30455848 http://dx.doi.org/10.5935/1984-0063.20180030 |
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author | Borsini, Eduardo Enrique Blanco, Magali Ernst, Glenda Montenegro, Paulina Salvado, Alejandro Nigro, Carlos |
author_facet | Borsini, Eduardo Enrique Blanco, Magali Ernst, Glenda Montenegro, Paulina Salvado, Alejandro Nigro, Carlos |
author_sort | Borsini, Eduardo Enrique |
collection | PubMed |
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/m(2) + 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. |
format | Online Article Text |
id | pubmed-6201519 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Brazilian Association of Sleep and Latin American Federation of
Sleep |
record_format | MEDLINE/PubMed |
spelling | pubmed-62015192018-11-19 Simulated intention-to-treat analysis based on clinical parameters of patients at high risk for sleep apnea derivated to respiratory polygraphy Borsini, Eduardo Enrique Blanco, Magali Ernst, Glenda Montenegro, Paulina Salvado, Alejandro Nigro, Carlos Sleep Sci Original Article 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/m(2) + 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. Brazilian Association of Sleep and Latin American Federation of Sleep 2018 /pmc/articles/PMC6201519/ /pubmed/30455848 http://dx.doi.org/10.5935/1984-0063.20180030 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Borsini, Eduardo Enrique Blanco, Magali Ernst, Glenda Montenegro, Paulina Salvado, Alejandro Nigro, Carlos Simulated intention-to-treat analysis based on clinical parameters of patients at high risk for sleep apnea derivated to respiratory polygraphy |
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 | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201519/ https://www.ncbi.nlm.nih.gov/pubmed/30455848 http://dx.doi.org/10.5935/1984-0063.20180030 |
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