The Generalizability of the Clinical Assessment Score-15 for Pediatric Sleep-Disordered Breathing.

Autor: Goldstein NA; Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York., Friedman NR; Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado., Nardone HC; Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware., Aljasser A; Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia., Tobey ABJ; Division of Pediatric Otolaryngology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh., Don D; Division of Otolaryngology-Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, California., Baroody FM; Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Comer Children's Hospital, Chicago, Illinois., Lam DJ; Division of Pediatric Otolaryngology, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon., Goudy S; Division of Pediatric Otolaryngology, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia., Ishman SL; Division of Pediatric Otolaryngology-Head and Neck Surgery and Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Arganbright JM; Department of Pediatric Otolaryngology, Children's Mercy Hospital, Kansas City, Missouri., Baldassari C; Department of Otolaryngology, Children's Hospital of The King's Daughters, Norfolk, Virginia, U.S.A., Schreinemakers JBS; Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York., Wine TM; Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado., Ruszkay NJ; Drexel University College of Medicine, Philadelphia, Pennsylvania., Alammar A; Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia., Shaffer AD; Division of Pediatric Otolaryngology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh., Koempel JA; Division of Otolaryngology-Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, California., Weedon J; Research Division, State University of New York Downstate Medical Center, Brooklyn, New York.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2020 Sep; Vol. 130 (9), pp. 2256-2262. Date of Electronic Publication: 2019 Nov 29.
DOI: 10.1002/lary.28428
Abstrakt: Objective: The Clinical Assessment Score-15 (CAS-15) has been validated as an office-based assessment for pediatric sleep-disordered breathing in otherwise healthy children. Our objective was to determine the generalizability of the CAS-15 in a multi-institutional fashion.
Methods: Five hundred and thirty children from 13 sites with suspected sleep-disordered breathing were recruited, and the investigators completed the CAS-15. Based on decisions made in the course of clinical care, investigators recommended overnight polysomnography, observation, medical therapy, and/or surgery. Two hundred and forty-seven subjects had a follow-up CAS-15.
Results: Mean age was 5.1 (2.6) years; 54.2% were male; 39.1% were white; and 37.0% were African American. Initial mean (standard deviation [SD]) CAS-15 was 37.3 (12.7), n = 508. Spearman correlation between the initial CAS-15 and the initial apnea-hypopnea index (AHI) was 0.41 (95% confidence interval [CI], 0.29, 0.51), n = 212, P < .001. A receiver-operating characteristic curve predicting positive polysomnography (AHI > 2) had an area under the curve of 0.71 (95% CI, 0.63, 0.80). A score ≥ 32 had a sensitivity of 69.0% (95% CI, 61.7, 75.5), a specificity of 63.4% (95% CI, 47.9, 76.6), a positive predictive value of 88.7% (95% CI, 82.1, 93.1), and a negative predictive value of 32.9% (95% CI, 23.5, 44.0) in predicting positive polysomnography. Among children who underwent surgery, the mean change (SD) score was 30.5 (12.6), n = 201, t = 36.85, P < .001, effect size = 3.1.
Conclusion: This study establishes the generalizability of the CAS-15 as a useful office tool for the evaluation of pediatric sleep-disordered breathing.
Level of Evidence: 2B Laryngoscope, 130:2256-2262, 2020.
(© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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