Refining screening questionnaires for prediction of sleep apnea severity in children
Purpose Screening instruments are poor predictors of the severity of pediatric obstructive sleep apnea (OSA). We hypothesized that their performance could be improved by identifying and eliminating redundant features. Methods Baseline scores from three screening questionnaires for pediatric OSA were...
Saved in:
Published in | Sleep & breathing Vol. 24; no. 4; pp. 1349 - 1356 |
---|---|
Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Cham
Springer International Publishing
01.12.2020
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Purpose
Screening instruments are poor predictors of the severity of pediatric obstructive sleep apnea (OSA). We hypothesized that their performance could be improved by identifying and eliminating redundant features.
Methods
Baseline scores from three screening questionnaires for pediatric OSA were obtained from the Childhood Adenotonsillectomy Trial (CHAT). The questionnaires included the (i) modified Epworth sleepiness scale (ESS), (ii) the sleep-related breathing disorders subscale of the pediatric sleep questionnaire (PSQ), and the (iii) obstructive sleep apnea-18 (OSA-18) scale. Key features from each questionnaire were identified using variable selection methods. These selected features (SF) were then assessed for their ability to predict the severity of OSA, measured by the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). In addition, prediction performance of SF was also calculated for AHI > 5 and > 10 and ODI > 5 and > 10, respectively.
Results
Four hundred fifty-three children aged 5–10 years were included. The majority of the pairwise correlations among the items within the 3 screening questionnaires were statistically significant. The prediction of AHI and ODI by overall questionnaire scores was poor. Four-item SF, comprising
apneic pauses, growth problems, mouth breathing,
and
obesity
predicted AHI and ODI significantly better than each of the individual questionnaires. Furthermore, SF also predicted AHI > 5 and > 10, as well as ODI > 5 and > 10 significantly better than the original questionnaires.
Conclusions
Elimination of redundant items in screening questionnaires improves their prediction performance for OSA severity in children with high pre-test probability for the condition. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1520-9512 1522-1709 |
DOI: | 10.1007/s11325-019-01964-7 |