Temporal and sleep stage-dependent agreement in manual scoring of respiratory events.

Autor: Pitkänen M; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.; Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland., Pitkänen H; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.; Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland., Nath RK; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.; VTT Technical Research Centre of Finland Ltd, Kuopio, Finland., Nikkonen S; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.; Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland., Kainulainen S; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.; Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland., Korkalainen H; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.; Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland., Ólafsdóttir KA; Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland., Arnardottir ES; Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland., Sigurdardottir S; Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland., Penzel T; Center of Sleep Medicine, University Hospital Charité Berlin, Berlin, Germany., Fanfulla F; Respiratory Function and Sleep Unit, Clinical Scientific Institutes Maugeri IRCCS, Pavia and Montescano, Italy., Anttalainen U; Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Central Hospital, Turku, Finland, and Sleep Research Centre, University of Turku, Turku, Finland., Saaresranta T; Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Central Hospital, Turku, Finland, and Sleep Research Centre, University of Turku, Turku, Finland., Grote L; Center for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden., Hedner J; Center for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden., Staats R; Department of Pneumology, ISAMB, Faculty of Medicine, University of Lisbon, Lisbon, Portugal., Töyräs J; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.; School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia.; Science Service Center, Kuopio University Hospital, Kuopio, Finland., Leppänen T; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.; Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland.; School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia.
Jazyk: angličtina
Zdroj: Journal of sleep research [J Sleep Res] 2024 Nov 04, pp. e14391. Date of Electronic Publication: 2024 Nov 04.
DOI: 10.1111/jsr.14391
Abstrakt: Obstructive sleep apnea diagnosis is based on the manual scoring of respiratory events. The agreement in the manual scoring of the respiratory events lacks an in-depth investigation as most of the previous studies reported only the apnea-hypopnea index or overall agreement, and not temporal, second-by-second or event subtype agreement. We hypothesized the temporal and subtype agreement to be low because the event duration or subtypes are not generally considered in current clinical practice. The data comprised 50 polysomnography recordings scored by 10 experts. The respiratory event agreement between the scorers was calculated using kappa statistics in a second-by-second manner. Obstructive sleep apnea severity categories (no obstructive sleep apnea/mild/moderate/severe) were compared between scorers. The Fleiss' kappa value for binary (event/no event) respiratory event scorings was 0.32. When calculated separately within N1, N2, N3 and R, the Fleiss' kappa values were 0.12, 0.23, 0.22 and 0.23, respectively. Binary analysis conducted separately for the event subtypes showed the highest Fleiss' kappa for hypopneas to be 0.26. In 34% of the participants, the obstructive sleep apnea severity category was the same regardless of the scorer, whereas in the rest of the participants the category changed depending on the scorer. Our findings indicate that the agreement of manual scoring of respiratory events depends on the event type and sleep stage. The manual scoring has discrepancies, and these differences affect the obstructive sleep apnea diagnosis. This is an alarming finding, as ultimately these differences in the scorings affect treatment decisions.
(© 2024 The Author(s). Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)
Databáze: MEDLINE
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