Validation of a clinical assessment score for pediatric sleep-disordered breathing
| Autor: | Alison Jackson, Sherry Fishkin, Nira A. Goldstein, Samir Fahmy, Dimitre G. Stefanov, Katharina D. Graw-Panzer, Jennifer S. Sarhis, Jeremy Weedon |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Intraclass correlation medicine.medical_treatment Polysomnography Risk Assessment Severity of Illness Index Body Mass Index Cohort Studies Age Distribution Sleep Apnea Syndromes Cronbach's alpha Adenoidectomy medicine Confidence Intervals Humans Prospective Studies Sex Distribution Child Behavior Checklist Child Observer Variation Sleep Apnea Obstructive Receiver operating characteristic medicine.diagnostic_test Anthropometry business.industry Incidence medicine.disease Confidence interval Obstructive sleep apnea Otorhinolaryngology Child Preschool Physical therapy Female business Follow-Up Studies |
| Zdroj: | The Laryngoscope. 122(9) |
| ISSN: | 1531-4995 |
| Popis: | Objectives/Hypothesis: To validate a clinical assessment score for pediatric sleep-disordered breathing. Study Design: Prospective instrument validation. Methods: One hundred children scheduled for overnight polysomnography were evaluated by a standardized history and physical examination and assigned a clinical assessment score. Parents completed the Obstructive Sleep Apnea (OSA)-18, the Pediatric Quality of Life Inventory (PedsQL) 4.0, and the Child Behavior Checklist questionnaires. Children with positive polysomnography underwent adenotonsillectomy or adenoidectomy. The identical assessments were performed at a mean follow-up of 8 months. Results: Item reduction yielded a score of 15 items (Clinical Assessment Score-15 [CAS-15]) that demonstrated the best internal consistency and predictive utility (Cronbach α = .80). Intraclass correlation (ICC) demonstrated good intrarater (ICC, 0.78; 95% confidence interval [CI], 0.58 to 0.89) and inter-rater agreement (ICC, 0.65; 95% CI, 0.26 to 0.84). All change scores were significantly improved after surgery. Effect sizes were large for the CAS-15 (2.6), OSA-18 (2.4), and apnea-hypopnea index (1.4), and moderate for the Child Behavior Checklist (0.7) and PedsQL 4.0 (−0.5). Moderate to strong correlation was found between the initial CAS-15 scores and the external measures (|r| between 0.32 and 0.65). Receiver operating characteristic curves were constructed to determine the optimal initial CAS-15 score for predicting positive polysomnography. The area under the curve was 0.77 (95% CI, 0.67 to 0.87); and a score ≥32 yielded a sensitivity of 77.3% (95% CI, 65.3 to 86.7) and a specificity of 60.7% (95% CI, 40.6 to 78.5). Conclusions: The CAS-15 proved useful in an office setting and correctly diagnosed 72% of referred children when compared to polysomnography. It correlated well with external measures and demonstrated a good response to clinical change. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text