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The Diagnostic Accuracy of OSA-18 in Identifying Moderate-to-Severe OSA in Snoring Children Who Have Normal/Inconclusive Overnight Oximetry
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A2004 - The Diagnostic Accuracy of OSA-18 in Identifying Moderate-to-Severe OSA in Snoring Children Who Have Normal/Inconclusive Overnight Oximetry
Author Block: S. Tansriratanawong1, S. Sritippayawan2, M. Veeravigrom3; 1Pediatric, King Chulalongkorn Memorial Hospital, Bangkok, Thailand, 2King Chulalongkorn Memorial Hosp, Bangkok, Thailand, 3King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Overnight oximetry has been widely used as a screening tool for pediatric obstructive sleep apnea (OSA). However, the test is limited by its low negative predictive value resulting in the need of confirmatory polysomnography (PSG) in snoring children who have normal/inconclusive study. Given the long waiting list of PSG, a screening tool for prioritizing children who need urgent PSG to confirm the diagnosis of OSA is crucial especially among those who are at risk for moderate-to-severe disease. Previous preliminary study presented as a poster discussion in the 2016 ATS International conference showed that OSA-18 could be used as a screening tool for this purpose. However, the study was performed in a limited number of children. We, therefore, performed the study in a larger sample size to validate the diagnostic accuracy of OSA-18 in identifying moderate-to-severe OSA in snoring children who had normal/ inconclusive overnight oximetry. One-hundred and thirty-three children were enrolled (mean age 6.5±2.7 yrs, 60.2% male). Primary snoring, mild OSA and moderate-to-severe OSA were diagnosed by PSG in 3, 42.1 and 54.9% of the study children, respectively. Mean total OSA-18 score was not different among the three groups (55.7, 67.3 and 70.2, respectively; p > 0.05). The area under the curve determined from ROC curve analysis of total OSA-18 score was 0.572 (95% CI 0.474-0.669; p = 0.156) suggesting the low diagnostic accuracy of total OSA-18 score in identifying moderate-to-severe OSA. In conclusion, more than a half of children who demonstrated normal/inconclusive overnight oximetry had moderate-to-severe OSA confirmed by PSG. OSA-18 had a poor diagnostic accuracy for identifying moderate-to-severe OSA and should not be used as a tool for prioritizing these children for urgent PSG
Author Block: S. Tansriratanawong1, S. Sritippayawan2, M. Veeravigrom3; 1Pediatric, King Chulalongkorn Memorial Hospital, Bangkok, Thailand, 2King Chulalongkorn Memorial Hosp, Bangkok, Thailand, 3King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Overnight oximetry has been widely used as a screening tool for pediatric obstructive sleep apnea (OSA). However, the test is limited by its low negative predictive value resulting in the need of confirmatory polysomnography (PSG) in snoring children who have normal/inconclusive study. Given the long waiting list of PSG, a screening tool for prioritizing children who need urgent PSG to confirm the diagnosis of OSA is crucial especially among those who are at risk for moderate-to-severe disease. Previous preliminary study presented as a poster discussion in the 2016 ATS International conference showed that OSA-18 could be used as a screening tool for this purpose. However, the study was performed in a limited number of children. We, therefore, performed the study in a larger sample size to validate the diagnostic accuracy of OSA-18 in identifying moderate-to-severe OSA in snoring children who had normal/ inconclusive overnight oximetry. One-hundred and thirty-three children were enrolled (mean age 6.5±2.7 yrs, 60.2% male). Primary snoring, mild OSA and moderate-to-severe OSA were diagnosed by PSG in 3, 42.1 and 54.9% of the study children, respectively. Mean total OSA-18 score was not different among the three groups (55.7, 67.3 and 70.2, respectively; p > 0.05). The area under the curve determined from ROC curve analysis of total OSA-18 score was 0.572 (95% CI 0.474-0.669; p = 0.156) suggesting the low diagnostic accuracy of total OSA-18 score in identifying moderate-to-severe OSA. In conclusion, more than a half of children who demonstrated normal/inconclusive overnight oximetry had moderate-to-severe OSA confirmed by PSG. OSA-18 had a poor diagnostic accuracy for identifying moderate-to-severe OSA and should not be used as a tool for prioritizing these children for urgent PSG
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