The discriminative power of STOP-Bang as a screening tool for suspected obstructive sleep apnea in clinically referred patients: considering gender differences
| Autor: | Jin Mou, Kimberly A. Mebust, Kirk T Harmon, S Shirley Ho, Brian A Crick, Stephen F Tarnoczy, Paul J. Amoroso, Bethann M. Pflugeisen |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurology Polysomnography Severity of Illness Index Body Mass Index 03 medical and health sciences Sex Factors 0302 clinical medicine Discriminative model Surveys and Questionnaires medicine Humans Mass Screening Cutoff Screening tool Aged Sleep Apnea Obstructive Sleep disorder Receiver operating characteristic business.industry Middle Aged medicine.disease Obstructive sleep apnea 030228 respiratory system Otorhinolaryngology Physical therapy Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Sleep and Breathing. 23:65-75 |
| ISSN: | 1522-1709 1520-9512 |
| Popis: | Obstructive sleep apnea (OSA) is the most commonly seen clinical sleep disorder. STOP-Bang, a widely used screening tool, yields a composite score based on eight dichotomized items including male gender. This study was designed to validate STOP-Bang among clinically referred patients and tested alternative scoring designs on tool performance, with a focus on gender differences in OSA. STOP-Bang was administered to 403 female and 532 male subjects, followed by comprehensive sleep evaluation that included measurement of apnea-hypopnea indexes. Gender differences in STOP-Bang scores, OSA diagnosis, and severities were explored, and gender-specific alternative score cutoffs evaluated. Optimal operating points (OOP) were tested for female body mass index (BMI) and male neck circumference to inform STOP-Bang threshold refinement. Receiver operating characteristic curves were used to compare conventional and modified STOP-Bang. STOP-Bang performance by gender showed extremely low specificity in males at the recommended cutoff of ≥3. Better utility was presented at a cutoff of 4 or 5 among clinically referred patients irrespective of gender differences. Screening performance was improved by modifying BMI and/or neck circumference thresholds using gender-triaged OOP estimation. Three gender-based model revisions outperformed conventional STOP-Bang. Our study suggests that gender-specific consideration needs to be incorporated into the application of STOP-Bang in a clinically referred patient population with a higher risk of OSA. Alternative scoring systems may improve predictive performance of STOP-Bang. |
| Databáze: | OpenAIRE |
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