Agreement in the scoring of respiratory events among international sleep centers for home sleep testing

Agreement in the scoring of respiratory events among international sleep centers for home sleep testing

Author Magalang, Ulysses J. Google Scholar
Arnardottir, Erna S. Google Scholar
Chen, Ning-Hung Google Scholar
Cistulli, Peter A. Google Scholar
Gislason, Thorarinn Google Scholar
Lim, Diane Google Scholar
Penzel, Thomas Google Scholar
Schwab, Richard Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Pack, Allan I. Google Scholar
Abstract Study Objectives: Home sleep testing (HST) is used worldwide to confirm the presence of obstructive sleep apnea (OSA). We sought to determine the agreement of HST scoring among international sleep centers. Methods: Fifteen HSTs, previously recorded using a type 3 monitor, were deidentified and saved in European Data Format. The studies were scored by nine technologists from the sleep centers of the Sleep Apnea Global Interdisciplinary Consortium (SAGIC) using the locally available software. Each study was scored separately using one of three different airflow signals: nasal pressure (NP), transformed (square root) nasal pressure signal (transformed NP), and uncalibrated respiratory inductive plethysmography (RIP) flow. Only one of the three airflow signals was visible to the scorer at each scoring session. The scoring procedure was repeated to determine the intrarater reliability. Results: The intraclass correlation coefficients (ICCs) using the NP were: apnea-hypopnea index (AHI) = 0.96 (95% confidence interval [CI]: 0.93-0.99)

apnea index = 0.91 (0.83-0.96)

and hypopnea index = 0.75 (0.59-0.89). The ICCs using the transformed NP were: AHI = 0.98 (0.96-0.99)

apnea index = 0.95 (0.90-0.98)

and hypopnea index = 0.90 (0.82-0.96). The ICCs using the RIP flow were: AH I = 0.98 (0.96-0.99)

apnea index = 0.66 (0.48-0.84)

and hypopnea index = 0.78 (0.63-0.90). The mean difference of first and second scoring sessions of the same respiratory variables ranged from -1.02 to 0.75/h. Conclusion: There is a strong agreement in the scoring of the respiratory events for HST among international sleep centers. Our results suggest that centralized scoring of HSTs may not be necessary in future research collaboration among international sites.
Keywords Home Sleep Testing
Sleep Study ScoringPositive Airway Pressure
Apnoea/Hypopnoea Syndrome
Hypopnea Syndrome
Language English
Sponsor NHLBI [P01 HL094307, HL093463]
National Center For Advancing Translational Sciences [UL1TR001070]
MonoMed Ltd.
Nox Medical
Grant number NHLBI: P01 HL094307
AIP: HL093463
UJM: UL1TR001070
Date 2016
Published in Journal Of Clinical Sleep Medicine. Westchester, v. 12, n. 1, p. 71-77, 2016.
ISSN 1550-9389 (Sherpa/Romeo, impact factor)
Publisher Amer acad sleep medicine
Extent 71-77
Access rights Closed access
Type Article
Web of Science ID WOS:000374135800011

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