A Convolutional Neural Network Architecture to Enhance Oximetry Ability to Diagnose Pediatric Obstructive Sleep Apnea

• Published in: IEEE journal of biomedical and health informatics Vol. 25; no. 8; pp. 2906 - 2916
• Main Authors: Vaquerizo-Villar, Fernando, Alvarez, Daniel, Kheirandish-Gozal, Leila, Gutierrez-Tobal, Gonzalo C., Barroso-Garcia, Veronica, Santamaria-Vazquez, Eduardo, Campo, Felix del, Gozal, David, Hornero, Roberto
• Format: Journal Article
• Language: English
• Published: United States IEEE 01.08.2021; The Institute of Electrical and Electronics Engineers, Inc. (IEEE)
• Subjects: Apnea; Apnea–hypopnea index (AHI); Artificial neural networks; Bayesian analysis; Computer architecture; Context; Convolution; convolutional neural networks (CNN); Deep learning; Desaturation; Diagnostic systems; Feature extraction; Indexes; Multilayers; Neural networks; Optimization; Oximetry; Oxygen content; pediatric obstructive sleep apnea (OSA); Pediatrics; Segments; Sleep; Sleep apnea; Sleep disorders; State-of-the-art reviews; Training
• DOI: 10.1109/JBHI.2020.3048901
• ISSN: 2168-2194; 2168-2208

This study aims at assessing the usefulness of deep learning to enhance the diagnostic ability of oximetry in the context of automated detection of pediatric obstructive sleep apnea (OSA). A total of 3196 blood oxygen saturation (SpO 2 ) signals from children were used for this purpose. A convolutional neural network (CNN) architecture was trained using 20-min SpO 2 segments from the training set (859 subjects) to estimate the number of apneic events. CNN hyperparameters were tuned using Bayesian optimization in the validation set (1402 subjects). This model was applied to three test sets composed of 312, 392, and 231 subjects from three independent databases, in which the apnea-hypopnea index (AHI) estimated for each subject (AHI CNN ) was obtained by aggregating the output of the CNN for each 20-min SpO 2 segment. AHI CNN outperformed the 3% oxygen desaturation index (ODI3), a clinical approach, as well as the AHI estimated by a conventional feature-engineering approach based on multi-layer perceptron (AHI MLP ). Specifically, AHI CNN reached higher four-class Cohen's kappa in the three test databases than ODI3 (0.515 vs 0.417, 0.422 vs 0.372, and 0.423 vs 0.369) and AHI MLP (0.515 vs 0.377, 0.422 vs 0.381, and 0.423 vs 0.306). In addition, our proposal outperformed state-of-the-art studies, particularly for the AHI severity cutoffs of 5 e/h and 10 e/h. This suggests that the information automatically learned from the SpO 2 signal by deep-learning techniques helps to enhance the diagnostic ability of oximetry in the context of pediatric OSA.