A new tool to screen patients with severe obstructive sleep apnea in the primary care setting : a prospective multicenter study
© 2022. The Author(s)..
BACKGROUND: The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting.
METHODS: Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed.
RESULTS: 194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763-0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863-0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7-92.1) and specificity of 67.8% (95% CI 55.1-78.3).
CONCLUSIONS: The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry: ClinicalTrials.gov; Name: PASHOS Project: Advanced Platform for Sleep Apnea Syndrome Assessment; URL: https://clinicaltrials.gov/ct2/show/NCT02591979 ; Identifier: NCT02591979. Date of registration: October 30, 2015.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
BMC pulmonary medicine - 22(2022), 1 vom: 15. Jan., Seite 38 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Peñacoba, Patricia [VerfasserIn] |
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| Links: |
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| Themen: |
Continuous positive airway pressure (CPAP) |
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| Anmerkungen: |
Date Completed 09.02.2022 Date Revised 09.02.2022 published: Electronic ClinicalTrials.gov: NCT02591979 Citation Status MEDLINE |
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| doi: |
10.1186/s12890-022-01827-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Peñacoba, Patricia |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A new tool to screen patients with severe obstructive sleep apnea in the primary care setting |b a prospective multicenter study |
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| 500 | |a published: Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT02591979 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a BACKGROUND: The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting | ||
| 520 | |a METHODS: Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed | ||
| 520 | |a RESULTS: 194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763-0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863-0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7-92.1) and specificity of 67.8% (95% CI 55.1-78.3) | ||
| 520 | |a CONCLUSIONS: The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry: ClinicalTrials.gov; Name: PASHOS Project: Advanced Platform for Sleep Apnea Syndrome Assessment; URL: https://clinicaltrials.gov/ct2/show/NCT02591979 ; Identifier: NCT02591979. Date of registration: October 30, 2015 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Continuous positive airway pressure (CPAP) | |
| 650 | 4 | |a Home sleep apnea test | |
| 650 | 4 | |a Obstructive sleep apnea | |
| 650 | 4 | |a Primary healthcare | |
| 650 | 4 | |a Screening model | |
| 650 | 4 | |a Sleep unit | |
| 700 | 1 | |a Llauger, Maria Antònia |e verfasserin |4 aut | |
| 700 | 1 | |a Fortuna, Ana María |e verfasserin |4 aut | |
| 700 | 1 | |a Flor, Xavier |e verfasserin |4 aut | |
| 700 | 1 | |a Sampol, Gabriel |e verfasserin |4 aut | |
| 700 | 1 | |a Pedro-Pijoan, Anna Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Grau, Núria |e verfasserin |4 aut | |
| 700 | 1 | |a Santiveri, Carme |e verfasserin |4 aut | |
| 700 | 1 | |a Juvanteny, Joan |e verfasserin |4 aut | |
| 700 | 1 | |a Aoiz, José Ignacio |e verfasserin |4 aut | |
| 700 | 1 | |a Bayó, Joan |e verfasserin |4 aut | |
| 700 | 1 | |a Lloberes, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Mayos, Mercè |e verfasserin |4 aut | |
| 700 | 0 | |a PASHOS Working Group |e verfasserin |4 aut | |
| 700 | 1 | |a Domínguez Olivera, Leandra |e investigator |4 oth | |
| 700 | 1 | |a Valverde Trillo, Pepi |e investigator |4 oth | |
| 700 | 1 | |a Santos Santos, MªÁngeles |e investigator |4 oth | |
| 700 | 1 | |a Farga Martínez, Mª Del Mar |e investigator |4 oth | |
| 700 | 1 | |a Reverté Simó, Montserrat |e investigator |4 oth | |
| 700 | 1 | |a Argemí Saburit, Núria |e investigator |4 oth | |
| 700 | 1 | |a Medrano Medrano, Casimira |e investigator |4 oth | |
| 700 | 1 | |a Puig García, Marineus |e investigator |4 oth | |
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